地塞米松、甲氧氯普胺联合托烷司琼预防剖宫产术中卡前列素氨丁三醇诱发恶心呕吐的效果.doc

地塞米松、甲氧***普***联合托烷司琼预防剖宫产术中卡前列素氨丁三醇诱发恶心呕吐的效果
[摘要]目的 探討地塞米松、甲氧***普***联合托烷司琼预防剖宫产术中卡前列素氨丁三醇诱发恶心呕吐的效果。方法 选取2015年1月~2018年1月于我g and adverse reactions (extrapyramidal reactions) after Carboprost Tromethamine was applied to parturients in each group for 5, 6-15, 16-30, 31-50 min. Results The incidence rates of nausea and vomiting in groups D, J and T were lower than that in the control group at all time points after medication (P<). The incidence ratesof nausea and vomiting in different time periods were different between groups D, J and T (P<). The incidence rates of nausea and vomiting in group J and T were lower than that in group D 5 min after medication (P<). There was no significant difference in nausea and vomiting incidence between J and T groups (P>). The incidence rates of nausea and vomiting in group J and group T were lower than that in group D at 6-15, 16-30 and 31-50 min after medication (P<). The incidence rates of nausea and vomiting in group T were lower than that in group J (P<). One case of suspected extrapyramidal reaction occurred in group J, and no adverse reactions occurred in other groups. Conclusion Dexamethasone+Metoclopramide+Tropisetron combined use has definite effect in preventing nausea and vomiting during cesarean section, which is worthy of further clinical research and application. [Key words] Dexamethasone; Metoclopramide; Tropisetron; Cesarean section; Carprost tromethamine
椎管内麻醉是择期剖宫产手术较为普遍的麻醉方式,该类麻醉下的产妇,因自身生理因素的干扰,产妇胃排空时间比较长,胃内压加大,下段食管括约肌压力下降,同时手术中产妇容易出现迷走反射,导致血流动力学改变,加之缩宫药物卡前列素氨丁三醇的副作用影响,因此容易致使产妇出现术后恶心呕吐(PONV)[1]。所以,如何有效、合理地治疗PONV产妇、如何预防PONV的出现成为手术麻醉医师关注的问题。据研究,女性、晕动症、术后使用阿片类药物、孕产妇本身生理反应均为PONV的高危因素[2]。本研究通过对在我院行腰硬联合联合麻下剖宫产术中应用卡前列素氨丁三醇的200例产妇进行分析,探讨地塞米松、甲氧***普***联合托烷司琼预防剖宫产术中卡前列素氨丁三醇诱发恶心呕吐的效果,具体研究内容如下。
1资料与方法

选取2015年1月~2018年1月于我院施行腰硬联合麻下剖宫产术中应用卡前列素氨丁三醇的200例产妇作为研究对象。孕龄38~42周;美国麻醉医师协会(ASA)分级为Ⅰ~Ⅱ级;年龄35~42岁,平均(±)岁;身高150~168 cm,平均(±)cm;体重60~75 kg,平均(±)kg;手術时间40~60 mi