CAJ | 학술논문

[目的]观察昂丹司琼联合地塞米松、小剂量氟哌利多对妇科子宫切除术后硬膜外自控镇痛期间恶心呕吐的防治效果.[方法]随机将100例腰-硬联合麻醉下行腹式子宫全切术的妇科患者分为三组:对照组(C组)20例不给任何止吐药；昂丹司琼组(0组)40例手术结束前静脉注射昂丹司琼8 mg;昂丹司琼+地塞米松+氟哌利多组(O+D+F组)40例,手术开始后静脉注射地塞米松10mg,手术结束前注射昂丹司琼8 mg,术毕均行患者自控硬膜外镇痛(PCEA),C组与O组镇痛泵配方为0.238％甲磺酸罗哌卡因+0.004％芬太尼液共100ml,O+D+F组在镇痛液中加入2.5mg氟哌利多.观察术后48 h内患者的镇痛效果和恶心呕吐发生情况.[结果]三组镇痛效果VAS评分比较差异无统计学意义(P＞0.05),O组术后24h内恶心呕吐发生率低于C组(P＜0.05),O+D+F组术后48 h内恶心呕吐发生率低于C组(P＜0.01),O+D+F组术后48 h内恶心呕吐发生率显著低于0组(P＜0.01).[结论]昂丹司琼单独应用能减少术后24h内恶心呕吐的发生率,昂丹司琼+地塞米松+氟哌利多三药联合应用更能有效降低术后48 h内的恶心呕吐的发生率.
[목적]관찰앙단사경연합지새미송、소제량불고리다대부과자궁절제술후경막외자공진통기간악심구토적방치효과.[방법]수궤장100례요-경연합마취하행복식자궁전절술적부과환자분위삼조:대조조(C조)20례불급임하지토약；앙단사경조(0조)40례수술결속전정맥주사앙단사경8 mg;앙단사경+지새미송+불고리다조(O+D+F조)40례,수술개시후정맥주사지새미송10mg,수술결속전주사앙단사경8 mg,술필균행환자자공경막외진통(PCEA),C조여O조진통빙배방위0.238％갑광산라고잡인+0.004％분태니액공100ml,O+D+F조재진통액중가입2.5mg불고리다.관찰술후48 h내환자적진통효과화악심구토발생정황.[결과]삼조진통효과VAS평분비교차이무통계학의의(P＞0.05),O조술후24h내악심구토발생솔저우C조(P＜0.05),O+D+F조술후48 h내악심구토발생솔저우C조(P＜0.01),O+D+F조술후48 h내악심구토발생솔현저저우0조(P＜0.01).[결론]앙단사경단독응용능감소술후24h내악심구토적발생솔,앙단사경+지새미송+불고리다삼약연합응용경능유효강저술후48 h내적악심구토적발생솔.
[Objective]To observe the preventive and curative effect of ondansetron combined with dexamethasone,and a small amount of droperidol on nausea and vomiting in patients with controlled epidural analgesia after gynecological hysterectomy.[Methods]Totally 100 patients underwent abdominal hysterectomy in combined spinal epidural anesthesia,were randomly divided into three groups:20 cases in control group ( Group C) were not given any antiemetics; 40 cases in ondansetron group (Group O)were given 8 mg ondansetron intraoperatively by intravenous injection; 40 cases in ondansetron,dexamethasone and droperidol group ( Group O + D + F) were given 10 mg dexamethasone intraoperatively by intravenous injection,8 mg ondansetron was injected at the end of operation,and patient controlled epidural analgesia ( PCEA )wasused postoperatively.In Group C and Group O,the analgesia formula were ropivacaine mesylate (0.238％) and fentanyl solution(0.004％) 100ml in all; In Group O + D + F,2.5mg droperidol was added to analgesic solution.In 48 hours after the operation,the effects of analgesia and incidences of nausea and vomiting were observed.[Results]There were no significant difference in the analgesic effect VAS scores between the three groups.The incidence of nausea and vomiting in Group O was significantly lower than that in Group C (P＜0.05) within 24 hours postoperatively.The incidence of nausea and vomiting in Group O + D + F was significantly lower than that in Group C (P＜0.01) within 48 hours postoperatively.And the incidence of nausea and vomiting in Group O + D + F was significantly lower than that in Group O (P＜0.01) within 48 hours postoperatively.[Conclusions]Ondansetron alone can reduce the of postoperative nausea and vomiting within 24 hours postoperatively.Combination of ondansetron,dexamethasone and droperidol can effectively reduce the incidence of postoperative nausea and vomiting within 48 hours postoperatively.