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地塞米松有效防治胸乳途径腔镜甲状腺术后恶心呕吐(修改稿重发)

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DOI:
作者:
张晖
ZhangHui
作者单位:
上海交通大学附属第六人民医院麻醉科
Department of Anesthesiology, Shanghai Sixth People’s Hospital, Shanghai Jiaotong University
关键词:
地塞米松；腔镜手术；甲状腺切除术；术后恶心呕吐
dexamethasone; Endoscopic surgery; Thyroidectomy; PONV
摘要:
[摘要]目的 胸乳途径腔镜甲状腺手术由于其美容等优势已越来越成为外科医生和病人的选择。本研究旨在探讨术前预防性给予地塞米松是否有效防治胸乳途径腔镜甲状腺手术术后恶心呕吐发生率。方法 60例择期行胸乳途径腔镜甲状腺手术的女性病人随机分成2组：地塞米松组（术前预防性给予地塞米松8mg）和对照组（术前给予生理盐水作为对照药物）。在术后出麻醉复苏室前和术后24小时进行恶心呕吐评分，运用VAS评分评价疼痛，术后24小时评价病人对术后恶心呕吐和疼痛的总体满意度。结果 术后出复苏室前恶心呕吐的发生率在地塞米松组为10%，对照组为40%，两组间有显著差异（P=0.007<0.05）。术后24小时恶心呕吐发生率在地塞米松组为13.3%，对照组为46.7%，两组间也有显著差异（P=0.005<0.05）。两组在VAS评分上无显著差异。结论 术前预防性使用地塞米松能有效防治胸乳途径腔镜甲状腺早期术后恶心呕吐的发生率。
[Abstract]Objective Endoscopic thyroidectomy using breast approach has been rapidly accepted by surgeons and patients because of its cosmetic advantages. The present study was conducted to estimate the impact of prophylactic dexamethasone on postoperative nausea and vomiting(PONV) after endoscopic thyroidectomy using breast appoach. Method Sixty female patients scheduled to undergo elective endoscopic thyroidectomy using breast approach under general anesthesia were enrolled. These patients were randomly allocated to receive either dexamethasone(8mg) or placebo-saline. PONV and pain were evaluated at the time of discharge from the postanesthesia care unit . At 24 hours postoperatively, PONV and overall patient satisfaction regarding PONV and pain were recorded. Results The incidence of PONV was 10% in the dexamethasone group and 40% in the placebo group at the time of discharge from the postanesthesia care unit. The incidence of PONV was 13.3% in the dexamethasone group and 46.7% in the placebo group at 24 hours postoperatively. Conclusion After endoscopic thyroidectomy using breast appoach, the use of preoperative dexamethasone can effectively prevents PONV during the early postoperative period.

 

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