2019 年第 2 期 第 14 卷

托烷司琼联合地塞米松对腹腔镜食管裂孔疝修补术患者术后恶心呕吐的影响

Effect of tropisetron combined with dexamethasone on postoperative nausea and vomiting in patients undergoing laparoscopic esophageal hiatal hernia repair

作者：阿里木江·司马义王晓丽徐桂萍唐冬梅

英文作者：

单位：830000乌鲁木齐，新疆维吾尔自治区人民医院麻醉科

英文单位：

关键词：食管裂孔疝；托烷司琼；地塞米松；术后恶心呕吐

英文关键词：

• 摘要：

• 【摘要】目的    探讨托烷司琼联合地塞米松对腹腔镜食管裂孔疝修补术患者术后恶心呕吐（PONV）的影响。方法    选择2016年6月至2018年1月在新疆维吾尔自治区人民医院行择期腹腔镜食管裂孔疝修补术的女性患者150例，完全随机分为地塞米松组、托烷司琼组和联合治疗组，各50例。患者均行全身麻醉，气管插管后5 min，地塞米松组静脉给予地塞米松5 mg；托烷司琼组静脉给予托烷司琼注射液5 mg；联合治疗组静脉给予托烷司琼5 mg和地塞米松5 mg。手术结束后24 h比较各组PONV发生情况和PONV视觉模拟评分。结果    地塞米松组和托烷司琼组PONV发生率和PONV视觉模拟评分均明显高于联合治疗组［20.0%（10/50）、12.0%（6/50）比4.0%（2/50）,（3.8±1.1）、（3.9±1.1）分比（2.4±0.6）分］，差异均有统计学意义（均P＜0.05），而地塞米松组与托烷司琼组比较差异均无统计学意义（均P＞0.05）。结论    托烷司琼联合地塞米松能有效降低腹腔镜食管裂孔疝修补术患者PONV发生率，是围术期减少PONV并发症较为理想的联合用药选择，效果优于单一用药。

• 【Abstract】Objective    To investigate the effect of tropisetron combined with dexamethasone on postoperative nausea and vomiting(PONV) in patients undergoing laparoscopic esophageal hiatal hernia repair. Methods    A total of 150 female patients undergoing laparoscopic esophageal hiatal hernia repair in People′s Hospital of Xinjiang Uygur Autonomous Region from June 2016 to January 2018 were randomly divided into dexamethasone group, tropisetron group and combined treatment group, with 50 cases in each group. All patients had general anesthesia; 5 minutes after tracheal intubation, the dexamethasone group was intravenously given 5 mg dexamethasone; the tropisetron group was intravenously given 5 mg tropisetron injection; the combined treatment group was intravenously given 5 mg tropisetron and 5 mg dexamethasone. Incidence of PONV and score of PONV Visual Analogue Scale were analyzed 24 h after operation. Results    Incidence of PONV and score of PONV Visual Analogue Scale in the dexamethasone group and tropisetron group were significantly higher than those in the combined treatment group［20.0%（10/50）,12.0%（6/50） vs 4.0%（2/50）; （3.8±1.1）,（3.9±1.1） vs （2.4±0.6）］（P＜0.05）; there was no significant difference between the dexamethasone group and tropisetron group(P＞0.05). Conclusion    Tropisetron combined with dexamethasone can effectively reduce the incidence of PONV after laparoscopic esophageal hiatal hernia repair.