摘要
目的 观察比较单一和多模式联合方法对甲状腺切除术后恶心呕吐（PONV）高危人群恶心呕吐发生率的控制作用.方法 将200例行甲状腺切除术的PONV高危人群（女性,有晕动症史或PONV史,非吸烟者,应用阿片类药）按随机数字表法分为5组,每组40例.单用药物组：手术结束前10 min分别给予恩丹西酮8 mg和胃复安10 mg（各稀释于10 mL生理盐水中静脉注射）;脐贴药物组：除围手术期给予恩丹西酮和胃复安两种药物外,入手术室即给予止吐脐贴;耳穴药物组：除围手术期给予恩丹西酮和胃复安两种药物外,入手术室即采用耳穴贴压;多模式组除围术期给予恩丹西酮和胃复安两种药物外,联合给予止吐脐贴和耳穴贴压;对照组：以等量生理盐水替代.观察5组患者术后24 h的痛觉模拟评分和发生恶心呕吐情况.结果 对照组（77.5%）、单用药物组（47.5%）、脐贴药物组（32.5%）、耳穴药物组（30.0%）、多模式组（7.5%）PONV的发生率5组间比较差异有统计学意义（P〈0.05）,对照组明显高于其他4组（P〈0.05或P〈0.01）,多模式组明显低于其他4组（P〈0.05或P〈0.01）;而脐贴药物组与耳穴药物组相近,均低于单用药物组,但差异均无统计学意义（均P〉0.05）.结论 对于行甲状腺切除术的PONV高危人群,多模式止吐方法联合使用优于双模式,双模式优于单一药物模式.
Objective To observe the comparisons among different antiemetic methods, using single or multiple methods in combination, to control the incidence of nausea and vomiting in people with high-risk of such occurrence after thyroidectomy.Methods 200 people with high-risk to develop post-operative nausea and vomiting （PONV） such as female, having the medical history of motion sickness or PONV, non-smoker, person with administration of opioids underwent thyroidectomy, and they were randomly divided into five groups by using a random number table, 40 cases in each group. Medicine group： the patients in this group received 8 mg ondansetron and 10 mg metoclopramide （each diluted in 10 mL of normal saline for intravenous injection） 10 minutes before the completion of surgery. Navel stick and medicine group： besides the two drugs in medicine group given in peri-operative period, the patients in this group received anti-nausea navel stick immediately after entering the operating room. Ear acupoint and medicine group： besides the above mentioned two drugs used in peri-operative period, the patients in this group were treated with ear acupoint stick and press therapy immediately after entering the surgical room. Combined-mode group： besides the above mentioned two drugs used in peri-operative period, the patients in this group were treated with the combination of anti-nausea navel stick and ear acupoint therapies. Control group： the patients in this group received equal amount of normal saline. After operation, the situations of pain sensation imitative score and the occurrence of nausea and vomiting of each case were observed for 24 hours in the five groups.Results The incidences of PONV were of statistically significant differences among control group （77.5%）, medicine group （47.5%）, navel stick medicine group （32.5%）, ear acupoint medicine group （30.0%） and combined-mode group （7.5%,P 〈 0.05 orP 〈 0.01）. The incidence of PONV in control group was significantly higher than the incidences in other four groups （P 〈 0.05 orP 〈 0.01）. The incidence of PONV in combined-mode group was obviously lower than the incidences of other four groups （P 〈 0.05 orP 〈 0.01）. The incidence of PONV in navel stick medicine group was similar to that in ear acupoint medicine group, and the incidences of PONV in the above two groups were both lower than the incidence in the medicine group, but the difference had no statistical significance （allP 〉 0.05）.Conclusion In the high-risk people with PONV after thyroidectomy, the therapeutic effect of combined use of multiple antiemetic methods is better than that of the double mode which is more effective than the single mode medicine method.
出处
《中国中西医结合急救杂志》
CAS
北大核心
2015年第5期531-534,共4页
Chinese Journal of Integrated Traditional and Western Medicine in Intensive and Critical Care
关键词
甲状腺切除术后
预防
术后恶心呕吐
Post-thyroidectomy
Prevention
Postoperative nausea and vomiting
