周敏　张天伟

【摘要】 目的 观察静脉应用昂丹司琼对腹腔镜胆囊切除术后恶心呕吐的预防作用。方法 100例全身麻醉下行腹腔镜胆囊切除术的患者， 随机分成昂丹司琼组及对照组， 每组50例。昂丹司琼组给予昂丹司琼， 对照组给予生理盐水。观察两组治疗效果。结果 术后0～12 h恶心、呕吐发生率昂丹司琼组与对照组比较， 差异有统计学意义（P<0.05）；昂丹司琼组术后0～24 h恶心呕吐发生率及挽救药物用量显著低于对照组， 差异有统计学意义（P<0.05）。结论 麻醉诱导前静脉推注昂丹司琼显著降低了腹腔镜胆囊切除术患者术后恶心呕吐的发生率， 值得推广应用。

【关键词】 昂丹司琼；腹腔镜胆囊切除术；术后恶心呕吐

DOI：10.14163/j.cnki.11-5547/r.2016.05.006

Preventive effect by ondansetron for postoperative nausea and vomiting in laparoscopic cholecystectomy ZHOU Min， ZHANG Tian-wei. Department of Anesthesiology， First Affiliated Hospital of Xiamen University， Xiamen 361003， China

【Abstract】 Objective To observe preventive effect by ondansetron for postoperative nausea and vomiting in laparoscopic cholecystectomy. Methods A total of 100 patients receiving laparoscopic cholecystectomy by general anesthesia were randomly divided into ondansetron group and control group， with 50 cases in each group. The ondansetron group received ondansetron， and the control group received normal saline. Curative effects of the two groups were observed. Results The difference of incidences of postoperative nausea and vomiting in 0～12 h had statistical significance between the ondansetron group and the control group （P<0.05）. The ondansetron group had obviously lower incidences of postoperative nausea and vomiting in 0～24 h and applied content of rescue medicine than the control group， and the difference had statistical significance （P<0.05）. Conclusion Intravenous injection of ondansetron before anesthesia induction can remarkable reduce incidences of postoperative nausea and vomiting in laparoscopic cholecystectomy. It is worth promoting and applying.

【Key words】 Ondansetron； Laparoscopic cholecystectomy； Postoperative nausea and vomiting

术后恶心呕吐是腹腔镜胆囊切除术（LC）后的常见并发症， 腹腔镜胆囊切除术后恶心呕吐发生率为44%～83%[1， 2]。术后恶心呕吐增加了患者的心理不适和术后恢复时间、导致伤口裂开延长住院时间。选择性5-羟色胺3（5-HT3）受体阻断剂对术后恶心呕吐有良好的预防作用， 本研究拟探讨昂丹司琼对腹腔镜胆囊切除术后恶心呕吐的影响。现报告如下。

1 资料与方法

1. 1 一般资料 选取100例全身麻醉下行腹腔镜胆囊切除术的患者（2012年5月～2014年12月期间病例）。排除标准：对本研究所用药物过敏、伴有明显恶心呕吐的胃肠道疾病、术前24 h服用止吐药的患者。患者进入手术室后， 常规监测无创血压、心电和血氧饱和度、呼气末CO2（ETCO2）， 面罩吸氧3 L/min。100例患者随机分为昂丹司琼组和对照组， 每组50例。两组患者一般资料比较差异无统计学意义（P>0.05）， 具有可比性。见表1。

1. 2 方法 昂丹司琼组静脉应用昂丹司琼8 mg（5 ml）， 对照组给予生理盐水5 ml。由于丙泊酚有抗呕吐作用， 本研究诱导及维持均避免使用丙泊酚。本研究所用昂丹司琼于麻醉诱导前缓慢静脉推注。……