地塞米松、托烷司琼和灵活手术体位对甲状腺切除手术后恶心呕吐的影响

发布时间：2018-04-14 07:25

本文选题：地塞米松 + 托烷司琼　；参考：《重庆医学》2017年17期

【摘要】：目的探讨地塞米松、托烷司琼联合灵活手术体位对甲状腺切除术后患者恶心呕吐症状和血浆胃动素和胃泌素的影响及可能机制。方法以该院2013年1月至2016年1月本院收治的96例行甲状腺手术的住院患者为研究对象,96例患者随机分为A组(诱导前予10mg地塞米松+术中灵活手术体位)、B组(术毕予4mg托烷司琼+术中灵活手术体位)和C组(诱导前予10mg地塞米松+术毕予4mg托烷司琼+术中灵活手术体位),每组32例。观察各组患者术后24、48h的恶心呕吐情况,测定各组患者麻醉前、术后24、48h血浆胃动素(MTL)和胃泌素(GAS)水平变化。结果术后24h各组恶心呕吐情况差异有统计学意义(χ2=15.564,P=0.016),C组0级患者比例高于A组和B组(P0.05),C组3级患者比例低于A组和B组(P0.05),A组和B组各级患者比例差异均无统计学意义(P0.05)。术后48h各组恶心呕吐情况差异有统计学意义(χ2=13.232,P=0.039),C组0级患者比例高于A组和B组(P0.05),C组2级和3级患者比例低于A组(P0.05),A组和B组各级患者比例差异均无统计学意义(P0.05)。各组患者麻醉前MTL和GAS水平差异均无统计学意义(F=1.875、2.010,P=0.138、0.129)。术后24、48h,C组患者MTL水平均低于A组和B组,且其差异均有统计学意义(F=6.393、10.201,P=0.019、0.000);C组患者GAS水平均高于A组和B组,且其差异均有统计学意义(F=7.141、16.932,P=0.010、0.000)。A组和B组患者在不同时间点MTL和GAS水平差异均无统计学意义(P0.05)。结论地塞米松、托烷司琼联合灵活手术体位可有效减少甲状腺切除术后恶心呕吐的发生,可降低血浆MTL水平,升高GAS水平,改善胃肠功能。
[Abstract]:Objective to investigate the effects of dexamethasone tropisetron combined with flexible posture on nausea and vomiting symptoms plasma motilin and gastrin after thyroidectomy.Methods from January 2013 to January 2016, 96 patients with thyroid surgery were randomly divided into two groups: group A (group B) treated with 10mg dexamethasone during dexamethasone operation.4mg tropisetron and C group (32 cases in each group) were treated with 10mg dexamethasone and 4mg tropisetron before induction.The levels of plasma motilin motilin (MTL) and gastrin (gastrin) were measured at 24 hours after anesthesia and 48 hours after operation.Results there was statistically significant difference in nausea and vomiting in all groups 24 hours after operation (蠂 ~ 2 ~ 2 ~ (15.564)). The proportion of grade 0 patients in group C was higher than that in group A and group B (P 0.05). There was no significant difference in the proportion of patients of grade 3 between group A and group B (P 0.05).48 hours after operation, there was significant difference in nausea and vomiting among all groups (蠂 ~ 2 ~ 2 ~ (13.232) P ~ (0.039)) group (P < 0.01). The proportion of grade 0 patients in group C was higher than that in group A and group B (P < 0.05). There was no significant difference in the proportion of patients of grade 2 and grade 3 between group A and group A (P 0.05) and group B (P < 0.05).There was no significant difference in the levels of MTL and GAS in each group before anesthesia.The level of MTL in group C was significantly lower than that in group A and group B at 24 hours after operation, and the difference was statistically significant. The level of GAS in group C was significantly higher than that in group A and group B, and the level of GAS in group C was higher than that in group A and group B.There was no significant difference in the levels of MTL and GAS between group A and group B at different time points.Conclusion dexamethasone and tropisetron combined with flexible posture can effectively reduce the incidence of nausea and vomiting after thyroidectomy, decrease plasma MTL level, increase GAS level and improve gastrointestinal function.
【作者单位】：河北医科大学第二医院麻醉科;
【基金】：河北省医学科学研究课题计划项目(20130467)
【分类号】：R614

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