昂丹司琼预防和治疗腹腔镜胆囊切除术后恶心呕吐的疗效观察

目的：观察并分析昂丹司琼预防和治疗腹腔镜胆囊切除术后恶心、呕吐反应的临床效果。方法86例慢性结石性胆囊炎患者在全麻下接受常规腹腔镜胆囊切除术。将其分为术前用药组36例、术后用药组25例和对照组25例。术前用药组于麻醉前30分钟通过静脉注射盐酸昂丹司琼8 mg、术后用药组麻醉清醒后立即给予静脉注射盐酸昂丹司琼8 mg，对照组不给予任何止吐药物。观察至术后48小时，统计各组中恶心、呕吐反应的发生例数和药物不良反应情况。结果86例患者共有25例发生恶心、呕吐反应。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27.8%、12.0%和48.0%。术后用药组与对照组相比有统计学意义（χ^2=7.71，P＜0.05），说明术后用药可减少术后恶心、呕吐的发生；术前用药组与对照组比较无统计学意义（χ^2=2.61，P＞0.05），说明术前用药不能预防术后恶心、呕吐的发生。25例患者术后发生恶心、呕吐，给予经静脉注射盐酸昂丹司琼8 mg，有21例患者缓解，缓解率为84.0%，用药过程中未发生药物不良反应。结论盐酸昂丹司琼预防和治疗LC术后恶心、呕吐是安全、有效的，预防性用药最佳时机应该为麻醉清醒时。

Effect of Ondansetron in Preventing and Treating Postoperative Nausea and Vomiting after Laparoscopic Cholecystectomy

Objective To explore the effect of ondansetron in preventing and treating postoperative nausea and vomiting （PONV） af-ter laparoscopic chlecystectomy （LC）. Methods 86 cases with chronic calculous cholecystitis were randomly divided into 3 groups be-fore routine laparoscopic cholecystectomy under general anesthesia：preoperative group （n=36）, postoperative group （n=25） and control group （n=25）;intravenous injection of ondansetron 8mg was made to patients in preoperative group 30 minutes before anesthesia while the injection was made to patients in postoperative group immediately on recovery from anesthesia;no antiemetic drugs were given to patients in control group;the observation lasted for 48 hours after operation and the occurrence of nausea, vomiting and side-effects in each group was statistically studied. Results PONV occurred in 25 cases among the 86 cases;the occurrence of PONV was 27.8%in preoperative group, 12%in postoperative group and 48%in control group;the difference between postoperative group and control group was of statistical significance （χ^2=7.71, P〈0.05）, which indicated that postoperative application of drugs could decrease the occurrence of PONV;the difference between preoperative group and control group was of no statistical significance （χ^2=2.61, P〉0.05）, which indi-cated that preoperative application of drugs could not prevent the occurrence of PONV; an intravenous injection of ondansetron 8mg was made to the 25 cases of PONV and relief was gained in 21 cases;no side-effect occurred. Conclusions Ondansetron is safe and ef-fective in preventing and treating PONV after LC, and the best time for preventive use of drugs is on the recovery from anesthesia.