微创医学

目的对比分析不同干预措施预防腹腔镜子宫肌瘤剔除术术后恶心呕吐(PONV)的临床效果。方法选择拟行腹腔镜子宫肌瘤剔除术的患者210例为观察对象，随机分为3组，每组70例。A组：麻醉诱导前10 min静脉注射生理盐水10 mL；B组：麻醉诱导前10 min静脉注射托烷司琼2 mg+地塞米松10 mg+氟哌利多2 mg；C组：麻醉诱导前10 min静脉注射托烷司琼2 mg+地塞米松10 mg，手术结束时静脉注射氟哌利多2 mg。观察患者术后24 h内PONV的发生情况。结果3组患者术后24 h内PONV发生率分别为：A组55.7%（39/70）、B组17.1%(12/70)、C组5.7%（4/70）。B、C组PONV发生率明显低于A组（P＜0.01），且PONV的严重程度明显低于A组（P＜0.05）；C组PONV发生率明显低于B组（P＜0.05）。结论麻醉诱导前10 min静脉注射托烷司琼2 mg+地塞米松10 mg，且手术结束时静脉注射氟哌利多2 mg能显著降低腹腔镜子宫肌瘤剔除术后PONV的发生率。

ObjectiveTo compare different interventions for preventing postoperative nausea and vomiting (PONV) after laparoscopic myomectomy. MethodsA total of 210 patients scheduled for laparoscopic myomectomy were selected and were randomly divided into 3 groups,with 70 cases in each group. At 10min before anesthesia induction, group A received intravenous injection of normal saline 10 ml, and group B received intravenous injection of tropisetron (10 mg), dexamethasone (10 mg) and droperidol (2 mg) . Group C received intravenous injection of tropisetron(2 mg) and dexamethasone (10 mg) at 10 min before anesthesia induction, then was intravenously injected of droperidol (2 mg) at the end of the operation.The incidence of PONV within 24 hours after surgery was observed. ResultsThe incident rates of PONV within 24 hours after surgery in group A, group B and group C were 55.7%（39/70）,17.1% (12/70)and 5.7% （4/70）respectively.The incident rate of PONV was lower (P＜0.01) and the severity of PONV was significantly milder (P＜0.05) in group B or group C compared to group A . The incident rate of PONV in group C was significantly lower than that in group B (P＜0.05). ConclusionIntravenous injection of tropisetron (2 mg) and dexamethasone (10mg) at 10 min before anesthesia induction combined with intravenous injection of droperidol (2 mg )at the end of the operation can effectively reduce the incidence of PONV after laparoscopic myomectomy.