腹腔镜胆囊切除术后恶心呕吐的防治

目的探讨腹腔镜胆囊切除术(LC)后恶心、呕吐反应的预防和治疗方法.方法 120例慢性结石性胆囊炎患者,男60例,女60例,均在全麻下接受常规LC手术.将其随机分为术前用药组40例、术后用药组40例和对照组40例,分别于麻醉前30min静脉注射盐酸蒽丹西酮8mg、麻醉清醒后立即给予静脉注射盐酸蒽丹西酮8mg和不给予任何镇吐药.用药后观察48h,观察恶心、呕吐反应的发生情况和药物的不良反应.若患者出现恶心、呕吐,再给予静脉注射盐酸蒽丹西酮8mg治疗.结果术前用药组、术后用药组和对照组的恶心、呕吐发生率分别为27.5%、10%和50%,术后用药组的恶心、呕吐发生率明显低于术前用药组和对照组(P＜0.05),术前用药组的恶心、呕吐发生率也明显低于对照组(P＜0.05);120例患者共有35例发生恶心、呕吐反应,再次静脉注射盐酸蒽丹西酮8mg后,有31例患者得到控制(88%).未观察到任何药物的不良反应.结论盐酸蒽丹西酮能安全有效地预防和治疗LC术后恶心、呕吐反应的发生.

The prophylaxis and treatment with ondansetron for the prevention of nausea and vomiting after laparoscopic cholecystectomy

Objective To explore the prophylaxis and treatment of nausea and vomiting after laparoscopic cholecystectomy(LC).Methods One hundred and twenty patients with chronic cholecystitis,60 men and 60 women,were undergone general anesthesia for elective LC .They were divided into three groups: the preoperative group,postoperative group and control group ,40 patients each group. The patients of preoperative group and postoperative group were given ondansetron 8mg intravenously 30 min before anesthesia and after wakening of anesthesia separately. The control group were given no antiemetic .The patients were observed for 48h after administration of drug and recorded the incidence of nausea and vomiting and the adverse effects of drug .If the patients occured nausea and vomiting ,they were given ondansetron 8mg intravenously again.Results The incidence of patients who occured nausea and vomiting was 27.5% with preoperative group,10% with postoperative group and 50% with control group .They were significant difference compared with each other(P<0.05) .There were 35 patients occured nausea and vomiting after LC.They were given ondansetron 8mg intravenously again and 31 patients were emesis-free .No clinically important adverse effects were observed in any of the groups.Conclusion Ondansetron,given intravenously ,were safe and effective for prophylaxis and treatment of nausea and vomiting after LC.