不同剂量昂丹司琼对无痛人流术孕妇的麻醉、苏醒效果及术后呕吐的影响

doi:10.3969/j.issn.1671-7171.2022.10.024

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摘要【目的】观察不同剂量昂丹司琼对无痛人工流产手术(人流术)孕妇的麻醉、苏醒效果及术后呕吐的影响。【方法】在两院接受无痛人流术治疗的192例孕妇,根据用药情况将其划分为对照组、低量组、中量组、高量组每组48例。各组均采用地佐辛复合丙泊酚麻醉,其中对照组不予止吐药物,低量组于麻醉前给予2 mg昂丹司琼,中量组于麻醉前给予4 mg昂丹司琼,高量组于麻醉前给予8 mg昂丹司琼。比较各组孕妇术中指标、术后恶心、呕吐程度与苏醒质量,术后随访24 h统计各组额外止吐药物的应用情况。【结果】四组孕妇手术时间、麻醉时间、术中平均心率、平均动脉压(MAP)相比较,差异均无统计学意义(P>0.05)。对照组恶心、呕吐发生率为43.75%(21/48),低量组为20.83%(10/48),中量组与高量组均为6.25%(3/48),低量组、中量组、高量组均低于对照组(P<0.05),中量组、高量组均低于低量组(P<0.05),中量组与高量组之间相比较,差异无统计学意义(P>0.05)。各组孕妇自主呼吸恢复时间、唤醒睁眼时间、指令握拳时间、苏醒期躁动程度评分相比较,差异均无统计学意义(P>0.05)。对照组额外止吐药物应用率为27.08%(13/48),低量组为10.42%(5/48),中量组为2.08%(1/48),高量组无额外止吐药物应用情况。低量组、中量组与高量组应用率相比较,差异均无统计学意义(P>0.05),对照组应用率分别高于低量组、中量组与高量组(P<0.05)。【结论】无痛人流术中应用地佐辛配合昂丹司琼能够有效降低术后恶心、呕吐的发生率并减轻其程度,且配伍用药安全,且4 mg昂丹司琼较2 mg效果理想,用量增加至8 mg时效果未见明显提升。

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	张竹青
	孟雅静

关键词 ：昂丹司琼, 流产,人工, 麻醉, 手术后恶心呕吐

Abstract：【Objective】 To observe the effects of different doses of ondansetron on the anesthesia, recovery and postoperative vomiting of pregnant women undergoing painless induced abortion . 【Methods】A total of 192 pregnant women who received painless induced abortion in both hospitals were divided into control group, low dose group, medium dose group and high dose group according to the medication situation; Each group was anesthetized with diazosine combined with propofol. The control group was not given antiemetic drugs. The low dose group was given 2 mg ondansetron before anesthesia, the medium dose group was given 4 mg ondansetron before anesthesia, and the high dose group was given 8mg ondansetron before anesthesia; The intraoperative indexes, postoperative nausea and vomiting degree and recovery quality of the pregnant women in each group were compared, and the use of additional antiemetic drugs in each group was counted after 24 h follow-up. 【Results】There was no significant difference in operation time, anesthesia time, mean heart rate and mean arterial pressure (MAP) among the four groups (P>0.05). The incidence of nausea and vomiting was 43.75% (21/48) in the control group, 20.83% (10/48) in the low dose group, 6.25% (3/48) in the middle dose group and the high dose group. The low dose group, the middle dose group and the high dose group were lower than the control group (P<0.05), and the middle dose group and the high dose group were lower than the low dose group (P<0.05). There was no significant difference between the middle dose group and the high dose group (P>0.05). There was no significant difference in the recovery time of spontaneous respiration, the time of awakening eyes, the time of clenching fists under command, and the dryness degree score during the awakening period among the pregnant women in each group (P>0.05). The application rate of additional antiemetic drugs in the control group was 27.08% (13/48), 10.42% (5/48) in the low dose group, 2.08% (1/48) in the medium dose group, and no additional antiemetic drugs were used in the high dose group. There was no significant difference in the application rate between low dose group, medium dose group and high dose group (P>0.05). The application rate of control group was higher than that of low dose group, medium dose group and high dose group (P<0.05). 【Conclusion】 Dezocine combined with ondansetron during painless induced abortion can effectively reduce the incidence and degree of postoperative malignant vomiting, and the combination of 4 mg ondansetron is safe. The effect of 4 mg ondansetron is better than that of 2 mg ondansetron, and the effect is not significantly improved when the dosage is increased to 8 mg.

Key words： Ondansetron Abortion, Induced Anesthesia Postoperative Nausea and Vomiting

收稿日期: 2022-02-20

中图分类号:

R719.7

通讯作者: *E-mail:xiwumyj@126.com

引用本文:

张竹青, 孟雅静. 不同剂量昂丹司琼对无痛人流术孕妇的麻醉、苏醒效果及术后呕吐的影响[J]. 医学临床研究, 2022, 39(10): 1528-1530.
ZHANG Zhu-qing, MENG Ya-jing. Effect of Different Doses of Ondansetron on Anesthesia and Postoperative Vomiting in Pregnant Women Undergoing Painless Induced Abortion. JOURNAL OF CLINICAL RESEARCH, 2022, 39(10): 1528-1530.

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http://journal07.magtech.org.cn/yxlcyj/CN/10.3969/j.issn.1671-7171.2022.10.024 或 http://journal07.magtech.org.cn/yxlcyj/CN/Y2022/V39/I10/1528

[1] 刘海军,徐蕾,陈龙,等.昂丹司琼预防地佐辛和丙泊酚无痛人流术后呕吐的效果研究[J].中国社区医师,2020,36(7):49-50.
[2] 张乃怿,高雨农.阿瑞匹坦联合地塞米松及昂丹司琼预防妇科肿瘤患者顺铂化疗引起的恶心呕吐的效果观察[J].实用妇产科杂志,2017,33(1):57-61.
[3] 白冰,裴丽坚,张越伦,等.吗啡静脉镇痛泵中加入昂丹司琼在女性术后恶心、呕吐预防中的应用[J].中国医学科学院学报,2018,40(3):373-377.
[4] KIM M S,PARK J H,CHOI Y S,et al.Efficacy of palonosetron vs.ramosetron for the prevention of postoperative nausea andvomiting:a meta-analysis of randomized controlled trials[J].Yonsei Med J,2017,58(4):848-858.
[5] 刘奇,张玉勤,杨宗林,等.经皮穴位电刺激联合昂丹司琼预防乳腺癌改良根治术后恶心呕吐40例[J].医药导报,2019,38(6):747-750.
[6] 凌学民,刘继群,骆慧芳.两种镇痛方法在人工流产手术中的临床比较[J].重庆医学,2015,44(12):1648-1649.
[7] 张天花,黄芬,周香珍.昂丹司琼与地塞米松分别联合阿瑞匹坦对妇科肿瘤患者化疗所致恶心呕吐的影响[J].中国临床药理学杂志,2020,36(14):1983-1985.
[8] YAZBECK-KARAM V G,SIDDIK-SAYYID S M,BARAKAT H B,et al.Haloperidol versus ondansetron for treatment of established nausea and vomiting following general anesthesia:a randomized clinical trial[J].Anesth Analg,2017,124(2):438-444.
[9] 李小洁.隔药灸联合昂丹司琼在预防铂类化疗药物致恶心呕吐的临床研究[J].实用癌症杂志,2020,35(5):863-866.
[10] 宋阳,李洋,郑文慧,等.术后恶心呕吐防治措施的研究进展[J].实用药物与临床,2017,20(6):720-724.
[11] 周雪峰,王石健,王金明,等.奥氮平联合昂丹司琼预防高致吐性化疗致延迟性恶心、呕吐的有效性及安全性[J].江苏医药,2018,44(9):26-29.