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中华普通外科学文献(电子版) ›› 2016, Vol. 10 ›› Issue (05) : 371 -374. doi: 10.3877/cma.j.issn.1674-0793.2016.05.012

所属专题: 文献

论著

帕洛诺司琼在加速康复外科中的作用
李坤河1, 邬艳1, 李毅2, 肖亮灿1,()   
  1. 1. 510080 广州,中山大学附属第一医院麻醉科
    2. 510080 广州,中山大学附属第一医院体外循环科
  • 收稿日期:2016-06-10 出版日期:2016-10-01
  • 通信作者: 肖亮灿
  • 基金资助:
    广东省自然科学基金资助项目(S2012010010965)

Role of palonosetron in enhanced recovery after surgery

Kunhe Li1, Yan Wu1, Yi Li2, Liangcan Xiao1,()   

  1. 1. Department of Anesthesiology, the First Affiliated Hospital of Sun Yat-senUniversity, Guangzhou 510080, China
    2. Department of Extracorporeal Circulation, the First Affiliated Hospital of Sun Yat-senUniversity, Guangzhou 510080, China
  • Received:2016-06-10 Published:2016-10-01
  • Corresponding author: Liangcan Xiao
  • About author:
    Corresponding author: Xiao Liangcan, Email:
引用本文:

李坤河, 邬艳, 李毅, 肖亮灿. 帕洛诺司琼在加速康复外科中的作用[J/OL]. 中华普通外科学文献(电子版), 2016, 10(05): 371-374.

Kunhe Li, Yan Wu, Yi Li, Liangcan Xiao. Role of palonosetron in enhanced recovery after surgery[J/OL]. Chinese Archives of General Surgery(Electronic Edition), 2016, 10(05): 371-374.

目的

探讨帕洛诺司琼在加速康复外科中的作用,为临床患者的围手术期康复提供更优质的服务。

方法

采用前瞻性、随机的研究方法,选择2015年9月至2016年2月拟行结直肠腹腔镜手术者120例,随机分为3组,各40例,各组术后行同配方的静脉镇痛。A组手术结束前1 h静推托烷司琼6 mg;B组手术结束前1 h静推帕洛诺司琼0.25 mg;C组手术结束前1 h静推帕洛诺司琼0.25 mg,静脉镇痛泵中静脉泵注帕洛诺司琼0.25 mg/72 h。记录并比较各组患者术后恶心、呕吐(PONV)等并发症发生率以及下床天数、出院时间。

结果

B组和A组术后恶心、呕吐发生率差异无统计学意义,C组较之A组、B组在术后24 h后PONV发生率差异有统计学意义(χ2=5.165、5.165,P=0.023、0.023);C组、B组较之A组术后镇痛24 h内除PONV外其余并发症发生率差异无统计学意义,24 h后除PONV外其余并发症发生率差异有统计学意义(χ2=4.500、6.275,P=0.033、0.012);C组较之A组、B组术后下床天数(t=3.718、2.975,P<0.001、0.004)、出院时间(t=6.650、5.440,均P<0.001)差异有统计学意义。

结论

帕洛诺司琼持续用药效果更稳定,可降低术后恶心、呕吐发生率,加速患者术后康复。

Objective

To investigate the role of palonosetron in enhanced recovery after surgery (ERAS), and to provide a better choice for perioperative clinical patients.

Methods

A prospective, randomized study was carried out, enrolling one hundred and twenty patients undergoing laparoscopic colorectal surgery from September 2015 to February 2016, who were randomly divided into three groups with 40 cases in each group. All patients were treated with postoperative intravenous analgesia (PCIA) in the same formulation. Group A (control group) were given i. v 6 mg bolustropisetron 1 hour before the end of the surgery; Group B i. v 0.25 mg boluspalonosetron; Group C i. v 0.25 mg bolus palonosetron, then added intravenous palonosetron 0.25 mg/72 h. The incidence of postoperative nausea and vomiting (PONV), complication in PCIA except PONV, ambulation after surgery, and hospital-stay days were recorded.

Results

The incidence of postoperative nausea and vomiting between Group B and Group A had no significant difference. Compared with Group A and Group B, the incidence of postoperative 24 h PONV in Group C was significantly different (χ2=5.165, 5.165, P=0.023, 0.023). The incidence of complication in PCIA except PONV between Group C and Group B, and Group C and Group A had significant differences after 24 h (χ2=4.500, 6.275, P=0.033, 0.012). Ambulation after surgery and the discharging days after surgery in Group C had significant differences compared to Group A and B (t=3.718, 2.975, P<0.001, 0.004; t=6.650, 5.440, both P<0.001).

Conclusion

Palonosetron continued injecting can more effectively reduce the incidence of postoperative nausea and vomiting, and improve the quality of rehabilitation.

表1 三组结直肠腔镜手术患者一般资料的比较(40例)
表2 三组结直肠腔镜手术患者术后静脉镇痛PONV发生率比较[n(%)]
表3 三组结直肠腔镜手术患者术后镇痛头晕、瘙痒等发生率比较[n(%)]
表4 三组结直肠腔镜手术患者术后下床时间、出院时间比较(d, ± s
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