术前预注不同剂量地塞米松对腹腔镜胆囊切除术患者术后恢复的影响

【目的】观察术前给予不同剂量的地塞米松对腹腔镜胆囊切除术（LC）患者术后恢复的影响。【方法】分析本院219例LC临床资料，术前分别予地塞米松8mg（A组）69例、地塞米松4rag（B组）71例、等剂量生理盐水（C组）79例。术后第1h、4h、6h、12h进行VAs镇痛评分，并记录术后不良反应。【结果】A、B组VAS镇痛评分均较C组显著降低（P〈0．05）；A组与B组相比，术后VAs评分差异无统计学意义（P〉0．05）。术后恶心、呕吐发生率A组明显低于B、C组（P〈0．05）。术后所需止痛药，A、B、C组差异无统计学意义（P〉0．05）。【结论】术前常规应用8mg地塞米松可减少LC患者术后疼痛，同时减少术后恶心呕吐发生率。

Effects of Preoperative Different Doses of Dexamethasone on Postoperative Complications of Laparoscopic Cholecystectomy Patients

Objective] To observe the different preoperative doses of dexamethasone on laparoseopic cholecystectomy （LC） patients. Methods]The clinical data of 219 cases of laparoscopic cholecystectomy in our hospital patients from March 2002 to December 2008 were retrospectively analyzed. Among them, 178 cases were operated with ＂fourhole method＂ and 41 cases were operated with ＂three-hole method＂. Group A （ n = 69） received preoperative dexamethasone 8mg. Group B （ n 271） received dexamethasone 4mg. Group C （ n=79） received equivalent doses of normal saline. At lh, 4h, 6h, 12h after operation, the VAS pain score and adverse reactions were evaluated. Results] The VAN pain scores of group A and group B were significantly lower than those in group C（ P〈0. 05）. There was no significant difference between group A and group B in postoperative VAS score （ P〉0.05）. The incidence of postoperative nausea and vomiting in group A was significantly lower than that in group C（ P〈0. 05）. And there were no significant differences among group A, group B and group C in postoperative pain medication requirements（ P〉0.05）. Conclusion] Preoperative routine administration with 8mg dexamethasone can reduce postoperative pain and the incidence of postoperative nausea and vomiting.