[1]贾东林,马友田,张利萍.术前扩容对腹腔镜胆囊切除术后患者恶心呕吐的影响[J].中国微创外科杂志,2008,08(1):16-18.
　Jia Donglin*,Ma Youtian,Zhang Liping*..Effect of Volume Expansion before Operation on Postoperative Nausea and Vomiting in Patients Undergoing Laparoscopic Cholecystectomy[J].Chinese Journal of Minimally Invasive Surgery,2008,08(1):16-18.
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术前扩容对腹腔镜胆囊切除术后患者恶心呕吐的影响()
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《中国微创外科杂志》[ISSN:1009-6604/CN:11-4526/R]

卷:
08
期数:
2008年1期
页码:
16-18
栏目:
出版日期:
2008-10-22

文章信息/Info

Title:
Effect of Volume Expansion before Operation on Postoperative Nausea and Vomiting in Patients Undergoing Laparoscopic Cholecystectomy
作者:
贾东林; 马友田;  张利萍
北京大学第三医院麻醉科，北京100083
Author(s):
Jia Donglin*;  Ma Youtian;  Zhang Liping*.
*Department of Anesthesiology, Third Hospital of Peking University, Beijing 100083, China
关键词:
术后恶心呕吐; 腹腔镜胆囊切除术; 扩容
Keywords:
Postoperative nausea and vomiting; Laparoscopic cholecystectomy; Volume expansion
分类号:
R614.2
文献标志码:
A
摘要:
目的观察术前补充10 ml/kg 6％中分子羟乙基淀粉(HES130/0.4，万汶)或10 ml/kg乳酸钠林格液对腹腔镜胆囊切除（laparoscopic cholecystectomy，LC）术后恶心呕吐的影响。方法60例ASAⅠ～Ⅱ级择期LC随机均分为三组，A组入手术室后至麻醉诱导前给予静脉输注2 ml/kg乳酸钠林格液，B组静脉输注10 ml/kg乳酸钠林格液，C组静脉输注10 ml/kg羟乙基淀粉。记录术前、诱导时及诱导后5、10、15 min及术毕时血压和心率，3组麻醉时间、手术时间，术后第1天随访患者恶心呕吐情况及需要补用止吐药例数。结果3组年龄、体重、麻醉时间、手术时间差异无显著性。诱导后3组平均动脉压较诱导前显著下降（Ｐ<0.05），A、B两组下降较C组明显（Ｐ<0.05）。术后24 h恶心呕吐发生率B组（7/20）和C组（6/20）明显低于A组（14/20）(χ2=4.912、6.400，Ｐ<0.05)，而B、C两组差异无显著性(χ2=0.114，Ｐ=0.736)。但3组间恶心呕吐分级无显著性差异（Ｐ>0.05）。需要给予止吐药的患者比例C组（1/20）低于A组（7/20）（χ2=3.906，P=0.048），B（3/20）、C两组间差异无显著性(χ2=0.278，Ｐ=0.598)。结论与术前补充2 ml/kg乳酸钠林格液相比，术前静脉输注10 ml/kg羟乙基淀粉或乳酸钠林格液均可降低LC患者术后恶心呕吐的发生率，前者还能降低术后需求止吐药的患者比例。
Abstract:
ObjectiveTo investigate the effect of HES 130/0.4 or sodium lactate Ringer’s solution injected before operation on postoperative nausea and vomiting (PONV) in patients undergoing laparoscopic cholecystectomy (LC).MethodsSixty patients (ASA ⅠⅡ) undergoing LC were randomly assigned to three groups: patients in group A were injected intravenously with 2 ml/kg sodium lactate Ringer’s solution before anesthesia; group B was given 10 ml/kg sodium lactate Ringer’s solution; and in group C, the patients were given 10 ml/kg 6% HES 130/0.4. The following data were recorded: blood pressure and heart rate before and after operation, and 0, 5, 10, and 15 min after induction; durations of anesthesia and operation; rate of PONV on the first postoperative day; and the number of cases who were given antiemetics. ResultsThe age, weight, and durations of anesthesia and operation were similar among the 3 groups. The MAP was decreased significantly after induction in the three groups (P<0.05). The decrease was more obvious in groups A and B than in group C (P<0.05). The rate of PONV in the group A (14/20) was significantly higher than that in the groups B (7/20) and C (6/20)(χ2=4.912 and 6.400, P<0.05). No significant difference in the rate of PONV was detected between groups B and C（χ2=0114,P=0736）. Whereas, the level of PONV was similar among the 3 groups (P>0.05). In the group A, 7 patients were given antiemetics that was significantly more than that in the groups B (3/20) and C (1/20). (A vs C, χ2=3906, P=0.048; B vs C, χ2=0.278, P=0.598) .ConclusionsCompared with 2 ml/kg sodium lactate Ringer’s solution, 10 ml/kg HES 130/0.4 or 10 ml/kg sodium lactate Ringer’s solution injected intravenously before operation may reduce the rate of PONV in patients undergoing LC, and decrease the proportion of those who need antiemetics after operation.

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备注/Memo

备注/Memo:
马友田（山东省寿光市人民医院麻醉科，寿光261000）
更新日期/Last Update: 2013-10-22