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| 多模式止吐疗法用于妇科腹腔镜术后恶心呕吐的临床效果 |
| 刘志强1,李海冰1,王珺1,陶怡怡1,陈秀斌1,俞卫锋2* |
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| (1. 同济大学附属第一妇婴保健院,上海 200040;2. 第二军医大学东方肝胆外科医院麻醉科,上海 200438) |
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| 摘要: |
| 目的评价多模式止吐疗法用于妇科腹腔镜术后恶心呕吐(PONV)的临床效果。方法选择接受妇科腹腔镜手术的患者90例随机分为3组,每组30例。A组(多模式组)采取包括应用普鲁泊福全凭静脉麻醉技术(TIVA)行麻醉诱导及维持,避免使用吸入麻醉药,最小化使用阿片药物,联合使用抗呕吐药物昂丹司琼4 mg、地塞米松2.5 mg及氟哌利多1.25 mg等措施的多模式止吐疗法进行PONV的防治；B组(联合用药组)采取联合应用抗呕吐药物法；C组(对照组)未采取特殊的PONV干预措施。观察并比较各组患者的一般情况、PONV风险预测、发生情况及总体满意率等指标。结果三组患者术前评估有较高的PONV预期发生率,A组和B组防治PONV的效果明显优于C组(P<0.05),在PONV完全效果例数和患者总体满意率方面,A组优于B组(P<0.05)。结论多模式止吐疗法可有效防治具有高危因素的妇科腹腔镜手术患者PONV,与只采用联合用药法比较,防治效果和患者满意率更佳。 |
| 关键词: 术后恶心呕吐 多模式止吐疗法 妇科外科手术 腹腔镜 |
| DOI：10.3724/SP.J.1008.2011.0447 |
| 投稿时间：2010-12-10修订日期：2010-12-10 |
| 基金项目:上海市卫生局基金 |
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| Multimodal antiemetic therapy for postoperative nausea and vomiting in patients receiving gynecological laparoscopic surgery |
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| Abstract: |
| [ABSTRACT] Objective:To assess the clinical effect of Multimodal Antiemetic Therapy on Postoperative Nausea and Vomiting in Patients Undergone Gynecological Laparoscopic Surgery. Methods:Ninety gynecologic patients scheduled for laparoscopic Surgery were randomly divided into three groups with 30 cases each. Group A (Multimodal Group) received multimodal antiemetic therapy including the management of using TIVA with propofol for induction and maintenance of anesthesia，avoidance of volatile anesthetics，minimization of opioids，combination of using antiemetics ondansetron 4mg + dexamethasone 2.5mg + droperidol 1.25mg for preventing PONV.Group B （Combination Group）received combination antiemetics therapy. Group C（Control Group）didn’t receive special interventions for PONV. Patient demographics,risk profiling,incidence of PONV and patient total satisfaction were observed and compared.Result: The preoperative expected risks of PONV in three groups were high. Group A and B were more effective than Group C in preventing PONV.Compared with Group B, Group A has a higher complete response rate and greater patient satisfaction. Conclusion：In Patients Undergone Gynecological Laparoscopic Surgery,evaluated to have a high risks of PONV preoperatively, multimodal antiemetic therapy has an effective prevention, also associated with a better clinical effect and greater patient satisfaction when compared with combination antiemetics therapy. |
| Key words: Postoperative nausea and vomiting,Therapy,Gynecological Surgery, Laparoscopy |
