帕洛诺司琼在加速康复外科中的作用

目的探讨帕洛诺司琼在加速康复外科中的作用，为临床患者的围手术期康复提供更优质的服务。 方法采用前瞻性、随机的研究方法，选择2015年9月至2016年2月拟行结直肠腹腔镜手术者120例，随机分为3组，各40例，各组术后行同配方的静脉镇痛。A组手术结束前1 h静推托烷司琼6 mg；B组手术结束前1 h静推帕洛诺司琼0.25 mg；C组手术结束前1 h静推帕洛诺司琼0.25 mg，静脉镇痛泵中静脉泵注帕洛诺司琼0.25 mg/72 h。记录并比较各组患者术后恶心、呕吐（PONV）等并发症发生率以及下床天数、出院时间。 结果B组和A组术后恶心、呕吐发生率差异无统计学意义，C组较之A组、B组在术后24 h后PONV发生率差异有统计学意义（χ²=5.165、5.165，P=0.023、0.023）；C组、B组较之A组术后镇痛24 h内除PONV外其余并发症发生率差异无统计学意义，24 h后除PONV外其余并发症发生率差异有统计学意义（χ²=4.500、6.275，P=0.033、0.012）；C组较之A组、B组术后下床天数（t=3.718、2.975，P<0.001、0.004）、出院时间（t=6.650、5.440，均P<0.001）差异有统计学意义。 结论帕洛诺司琼持续用药效果更稳定，可降低术后恶心、呕吐发生率，加速患者术后康复。

Role of palonosetron in enhanced recovery after surgery

ObjectiveTo investigate the role of palonosetron in enhanced recovery after surgery (ERAS), and to provide a better choice for perioperative clinical patients. MethodsA prospective, randomized study was carried out, enrolling one hundred and twenty patients undergoing laparoscopic colorectal surgery from September 2015 to February 2016, who were randomly divided into three groups with 40 cases in each group. All patients were treated with postoperative intravenous analgesia (PCIA) in the same formulation. Group A (control group) were given i. v 6 mg bolustropisetron 1 hour before the end of the surgery; Group B i. v 0.25 mg boluspalonosetron; Group C i. v 0.25 mg bolus palonosetron, then added intravenous palonosetron 0.25 mg/72 h. The incidence of postoperative nausea and vomiting (PONV), complication in PCIA except PONV, ambulation after surgery, and hospital-stay days were recorded. ResultsThe incidence of postoperative nausea and vomiting between Group B and Group A had no significant difference. Compared with Group A and Group B, the incidence of postoperative 24 h PONV in Group C was significantly different (χ²=5.165, 5.165, P=0.023, 0.023). The incidence of complication in PCIA except PONV between Group C and Group B, and Group C and Group A had significant differences after 24 h (χ²=4.500, 6.275, P=0.033, 0.012). Ambulation after surgery and the discharging days after surgery in Group C had significant differences compared to Group A and B (t=3.718, 2.975, P<0.001, 0.004; t=6.650, 5.440, both P<0.001). ConclusionPalonosetron continued injecting can more effectively reduce the incidence of postoperative nausea and vomiting, and improve the quality of rehabilitation.