全髋置换患者术后呕吐的原因探析

目的探究全髋关节置换术后患者出现呕吐现象的原因。方法选取2009年3月至2012年5月间入我院进行全髋关节置换术的患者58例,分析其呕吐现象出现的原因,主要为手术创伤、麻醉药物作用、饮食结构、卧床时间等因素,并制定护理对策。结果选取同期入院实施手术的患者58例,实施护理对策,结果出现呕吐现象患者1例,比例为1.72%,较之前17.24%发生比率下降显著。结论全髋关节置换术后胃肠道不良反应的发生要做好预防和护理,降低对患者康复的影响。     

雷莫司琼预防大剂量顺铂化疗所致呕吐的临床效果

目的观察雷莫司琼的止吐疗效和毒性。方法对28例接受大剂量顺铂化疗的患者,采用随机自身对照的方法,比较雷莫司琼和枢复宁在相等剂量下的疗效和毒性。结果雷奠司琼能有效预防顺铂所致的恶心、呕吐,其止吐效果与枢复宁相似。两药的止吐有效率分别为69.8%和60.5%,完全缓解率分别为59.5%和53.1%。两药的疗效无统计学差异,且毒副反应小。结论雷莫司琼为肿瘤化疗安全、有效的止吐药,值得临床推广应用。     

不同时机应用格拉司琼对预防全身麻醉术后恶心呕吐的影响

目的 探讨不同时机应用格拉司琼对预防全身麻醉术后恶心呕吐的影响。方法 选择择期气管插管全身麻醉手术的患者48例，按应用格拉司琼的不同时间将患者随机分为三组：A组：麻醉诱导完毕即刻；B组：麻醉诱导完毕后1h；C组：术毕拔出气管导管后。记录术后24h内恶心呕吐的发生情况。结果 术后恶心发生率及术后呕吐发生率在A组与B组间比较差异均无统计学意义（P〉0．05）。C组的术后恶心发生率及术后呕吐发生率明显低于A组与B组（P〈0．05）。结论 格拉司琼在预防术后恶心呕吐时，建议在术毕应用。     

恩丹西酮与地塞米松联合应用预防腹腔镜术后恶心呕吐效果观察

目的观察恩丹西酮单独应用及恩丹西酮与地塞米松联合用于防治腹腔镜手术后病人的恶心、呕吐效果。方法择期行腹腔镜手术ASAⅠ-Ⅱ级病人88例，随机分为3组：对照组15例，给予静脉注射生理盐水5ml，其余2组分别给予单独静脉注射恩丹西酮8mg（30例）和静脉注射恩丹西酮8mg＋地塞米松10mg处理（43例）。观察术后24h恶心呕吐情况。结果24h内对照组恶心、呕吐发生率显著高于处理2组（P〈0．01）；在2组处理组间进行比较，联合用药组恶心、呕吐发生率显著低于单用恩丹西酮组（P〈0．05）。结论恩丹西酮能降低腹腔镜手术后恶心、呕吐发生率，恩丹西酮与地塞米松联合应用效果更佳。     

Sevoflurane vs. isoflurane: a clinical comparison in day surgery

Discharge times after ambulatory surgery are determined by postoperative complications and in particular by the presence and severity of nausea and vomiting. Sevoflurane has become a popular agent for day-case surgery despite little evidence of clear advantages over current alternatives. We compared this agent with isoflurane in day-case patients undergoing knee arthroscopy in order to quantify the incidence of complications associated with each agent. One hundred and eighty patients received a standardised anaesthetic induction with propofol and fentanyl followed by maintenance with either isoflurane or sevoflurane. Standardised postoperative analgesic and anti-emetic drugs were prescribed. Any intra-operative cardiovascular or respiratory instability was recorded. After surgery, nausea, vomiting and pain were assessed. Almost all patients made an uneventful recovery and were discharged as scheduled. There was a significantly higher incidence of complications in the sevoflurane group. These included the presence of nausea and vomiting, and cardiovascular and respiratory complications. We found nothing to commend the routine use of sevoflurane rather than isoflurane in the context of day case anaesthesia.     

盐酸托烷司琼预防妇科患者术后自控硬膜外镇痛致恶心、呕吐的临床疗效观察

目的:观察盐酸托烷司琼用于预防妇科患者术后自控硬膜外镇痛(PCEA)致恶心、呕吐的效果。方法:将120例妇科手术后均行PCEA的患者随机分为2组,T组为盐酸托烷司琼组,N组为对照组,每组60例,观察2组用药后的恶心、呕吐发生率。结果:T组48h内恶心、呕吐发生率明显低于N组(P<0.05)。结论:盐酸托烷司琼预防妇科术后PCEA患者恶心、呕吐的发生安全、有效。     

盐酸格拉司琼防治含铂方案化疗引起恶心呕吐疗效观察

目的观察盐酸格拉司琼预防顺铂化疗呕吐的疗效。方法对128例接受顺铂方案化疗的患者,采用随机分组的方法,分别应用盐酸格拉司琼和恩丹西酮,观察两药止吐疗效。结果盐酸格拉司琼和恩丹西酮均能有效防治顺铂所致的恶心、呕吐,两药的止吐有效率分别为90%和86.8%,P<0.05。两药的副反应轻,主要为头痛、便秘等。结论盐酸格拉司琼能有效预防顺铂所致胃肠反应,不良反应轻,是良好的止吐药物。     

天晴日安治疗化疗后恶心呕吐的临床研究

目的观察选择性5-HT3受体拮抗剂———盐酸阿扎司琼氯化钠(天晴日安)预防化疗所致的消化道反应的临床疗效。方法随机选择52例化疗患者,治疗组26例,天晴日安10 mg,化疗前30 m in静注;对照组26例,盐酸恩丹西酮8 mg,静推,化疗前后15 m in应用。结果天晴日安对急性恶心的有效率为96.2%,恩丹西酮为92.3%;天晴日安对急性呕吐的有效率为100%,恩丹西酮为88.5%。天晴日安组便秘发生率42.3%,恩丹西酮组57.7%。结论天晴日安对化疗所致恶心呕吐具有良好的治疗作用,副作用小,且无锥体外系症状。