文章摘要
甘露醇复合多模式镇吐措施预防甲状腺术后恶心呕吐的观察
Observation of effects of mannitol combined with multimodal antiemetic therapy in patients of postoperative nausea and vomiting undergoing thyroidectomy
  
DOI：
中文关键词: 甲状腺术  甘露醇  多模式镇吐
英文关键词: Thyroidectomy  Mannitol  Multimodal antiemetic therapy
基金项目:
作者单位
张志强 050000,石家庄市,河北医科大学第二医院麻醉科 
底旺 050000,石家庄市,河北医科大学第二医院甲状腺乳腺外科 
张山 050000,石家庄市,河北医科大学第二医院麻醉科 
边庆虎 050000,石家庄市,河北医科大学第二医院麻醉科 
孟雅静 050000,石家庄市,河北医科大学第二医院麻醉科 
贾建丽 050000,石家庄市,河北医科大学第二医院麻醉科 
李清怀 050000,石家庄市,河北医科大学第二医院甲状腺乳腺外科 
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中文摘要:
      目的 观察甘露醇复合多模式镇吐措施预防甲状腺术后头晕头痛及术后恶心呕吐(PONV)的临床效果。方法 择期行甲状腺切除术患者100例，男39例，女61例，ASA Ⅰ或Ⅱ级，按照随机数字表随机均分为两组:对照组(C组)和甘露醇复合多模式镇吐组(M组)。两组患者均采用丙泊酚和瑞芬太尼全凭静脉麻醉(TIVA)方法。麻醉诱导后静脉注射地塞米松10 mg,手术结束前30 min给予盐酸帕洛诺司琼注射液0.25 mg。M组在手术结束前30 min快速静注甘露醇2 ml/kg,C组给予等量的生理盐水。观察术后24 h内两组患者头晕头痛及PONV的发生率。结果 M组术后24 h内头晕头痛发生率为5例(10%),PONV发生率5例(10%),明显低于C组的15例(30%)和12例(24%) (P＜0.05),术后24 h内额外使用止吐药M组为2例(4%),明显少于C组的9例(18%)(P＜0.05)。结论 术前给予地塞米松、术毕前30 min给予强效止吐剂帕洛诺司琼并复合脱水药甘露醇进行多模式镇吐可显著降低甲状腺术后头晕头痛及PONV的发生率。
英文摘要:
      Objective To evaluate the efficacy of multimodal antiemetic therapy on postoperative dizziness, headache, nausea and vomiting (PONV) in patients undergoing thyroidectomy. Methods One hundred patients (39 males and 61 females, ASA physical status Ⅰ or Ⅱ) scheduled for thyroidectomy were randomly divided into two groups according to random number table: control group (group C) and multimodal antiemetic therapy group (group M). Two groups received total intravenous anesthesia (TIVA) with propofol and remifentanil. Prophylactic dexamethasone 10 mg were given after anesthesia induction and palonosetron hydrochloride 0.25 mg was used 30 min before the end of surgery in both groups. Mannitol 2 ml/kg in group M and the same amount of normal saline in group C were given 30 min before the end of surgery. The incidence of dizziness, headache and PONV were observed for 24 h in two groups. Results The incidence of headache was 5 cases (10%)and PONV was 5 cases (10%) in group M, which were respectively significantly lower than that of group C of 15 cases (30%) and 12 cases (24%) in 24 h after surgery (P＜0.05). The additional antiemetic therapy for 24 h after surgery in group M of 2 cases (4%) was significantly lower than that of group C of 9 cases (18%) (P＜0.05). Conclusion The multimodal antiemetic therapy: prophylactic dexamethasone, palonosetron hydrochloride and mannitol were used 30 min before the end of surgery could significantly reduce the incidence of dizziness, headache and PONV after thyroidectomy.
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