帕洛诺司琼与托烷司琼治疗妇科腹腔镜手术患者术后恶心呕吐的效果比较

摘要

Objective To analyze effects of palonosetron and tropisetron in treating postoperative nausea and vomiting(PONV) after gynecological laparoscopic operation.Methods Totally 80 patients who were to havegynecological laparoscopic operation under general anesthesia from May to December 2015 in Beijing Youan Hospital,Capital Medical University were enrolled and randomly divided into tropisetron group and palonosetron group,with 40 cases in each group.Tropisetron(5 mg) and palonosetron(0.075 mg) were intravenous injected when anesthesia was induced.Clinical data,operation duration,anesthesia duration,occurrences of PONV at postoperative 0-6 h,＞6-24 h,＞24-48 h,nausea severity[visual analogue scale(VAS) score],drug use for PONV,the incidence of adverse reactions and postoperative 48 h satisfaction were analyzed.Results General clinical data,operation duration,anesthesia duration,VAS score,drug use for PONV,the incidence of adverse reactions and postoperative 48 h satisfaction had no significant differences between groups (P ＞ 0.05).Incidences of PONV at postoperative 24-48 h and 0-48 h in palonosetron group were significantly lower than those in tropisetron group[nausea:10.0％(4/40) vs 27.5％ (11/40),30.0％ (12/40) vs 55.0％ (22/40);vomiting:0.0％ (0/40) vs 7.5％ (3/40),17.5 ％ (7/40) vs 35.0％ (14/40)] (P ＜ 0.05).Conclusion Intravenous injection of palonosetron can significantly reduce the incidence of PONV after gynecological laparoscopic operation compared to tropisetron.%目的 比较帕洛诺司琼与托烷司琼减少妇科腹腔镜手术患者术后恶心、呕吐的效果.方法 选择2015年5-12月于首都医科大学附属北京佑安医院拟行择期妇科腹腔镜手术患者80例,根据随机数字表法将所有患者分为托烷司琼组和帕洛诺司琼组,各40例.2组均在全身麻醉诱导即刻给药,托烷司琼组给予单次剂量的托烷司琼5 mg静脉注射,帕洛诺司琼组给予单次剂量的帕洛诺司琼0.075 mg静脉注射.记录并比较2组一般资料、手术时间、麻醉时间、术后0～6h、＞6～24 h、＞24～48 h恶心、呕吐发生情况,记录患者术后恶心程度[疼痛视觉模拟量表(VAS)评分],恶心、呕吐补救用药情况以及不良反应发生情况和术后48 h满意度.结果 2组一般资料、手术时间、麻醉时间、术后补救用药患者比例、VAS评分、不良反应发生率及满意度比较,差异均无统计学意义(均P＞0.05).帕洛诺司琼组术后＞24～48 h以及0～48 h恶心、呕吐发生率均明显低于托烷司琼组[恶心:10.0％(4/40)比27.5％ (11/40),30.0％(12/40)比55.0％ (22/40);呕吐:0.0％ (0/40)比7.5％ (3/40),17.5％ (7/40)比35.0％ (14/40)],差异均有统计学意义(均P ＜0.05).结论 与静脉注射5 mg托烷司琼比较,静脉注射0.075 mg帕洛诺司琼能明显减少全身麻醉下妇科腹腔镜手术患者术后恶心、呕吐发生率.