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1、腹腔镜胆囊切除术后恶心呕吐反应相关因素研究及昂丹司琼治疗效果观察［摘要］目的探讨腹腔镜胆囊切除术（LC）后恶心呕吐反应的相关因素并对昂丹司琼预防恶心呕吐疗效进行观察。方法将76例行LC治疗的患者随机分为治疗组与对照组,治疗组在LC术后静脉注射昂丹司琼，观察患者术后恶心呕吐（PONV）的发生率、体重指数（BMI）、气腹压力、手术时间、芬太尼用量、麻醉复苏时间、术后VAS评分、肌松剂用量、住院天数以及血清5-轻色胺（5-HT）浓度等，并针对PONV发生率进行Logistic回归分析。结果P0NV发生率与BMI、芬太尼用量、麻醉恢复时间以及血清5-HT水平显著相关，差异有统计学意义
2、（P<0.05）；患者LC术后5-HT水平显著升高（P<0.05）,术后应用昂丹司琼可明显抑制5-HT水平升髙与PONV发生率。结论PONV与BMI.芬太尼用量、麻醉恢复时间以及血清5-HT水平相关，昂丹司琼可有效抑制血清5-HT水平升高并降低PONV发生率。［关键词］腹腔镜胆囊切除术；术后恶心呕吐；5-释色胺；昂丹司琼［中图分类号］R619［文献标识码］A［文章编号］1673-7210(2012)08(a)-0086-02Analysisofrelatedfactorsonpostoperativenauseaandvomitingoflaparoscopiccholecy
3、stectomyandtreatmenteffectofOndansetronSHENGMingHUANGHaofuLUOChengfuDepartmentofGeneralSuegery,HanshouPeople"sHospitalofChangdeCity,Hu"nanProvince,Hanshou415900,China[Abstract]ObjectiveTodiscussrelatedfactorsofnauseaandvomitingafterlaparoscopiccholecystectomy(LC)andtoobserveeffectofOndanset
4、rononnauseaandvomiting.Methods76patientsreceivedLCweredividedintotreatmentgroupandcontrolgroup・Patientsintreatmentgroupweretreatedwith4mgofOndansetron(iv)afterLC.Logisticanalysiswasappliedtoamalyzepostoperativenauseaandvomiting(PONV)incidencerate,bodymassindex(BMI),pneumoperitoneumpressure,
5、operationtime,dosageofFentanyl,anesthesiarecoverytime,post—operationVASscore,anddosageofmusclerelaxantandserum5~HTconcentratiori.ResultsIncidenceofPONVwasfoundcorrelatedcloselywithBMI,anesthesiarecoverytime,dosageofFentanylandserum5~HTconcentration；5~HTconcentrationwasfoundincreasedsignific
6、antlyincontrolgroupafterLC(P<0.05),andatmeantime,increaseof5-HTanddecreasedPONVincidenceratewereblockedbyapplicationofOndansetronintreatmentgroupsignificantly(P<0.05).ConelusionPONVishighlyrelatedwithBMI,anesthesisrecoverytime,dosageofFentanylandserum5~HTconcentration；Ondansetronshowseffect
7、sofdecreasingincidenceofPONVandinhibitingincreasinglevelof5-HT.[Keywords]Laparoscopiccholecystectomy；PONV；5-HT；Ondansetron目前腹腔镜在临床上已经被广泛应用，虽然腹腔镜疗效肯定且有诸多优点，但腹腔镜手术后常并发术后恶心呕吐(postoperativenauseaandvomiting,PONV)o据统计，PONV的总发生率为25%〜30%，腹腔镜胆囊切除术（LC）后PONV发生率为50
