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-=
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T?]
?a
á
?1 e?e0?|s￥
"543
6D’|ù
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lóqvD?2Dy
?J S
2óTμ9Dy
?J S
?yS2`y?2
óq430017
óq400613
【K1】"￥)-=
3j?]ó0Z
T
?aá
?1 e?e0?|s(PONV)￥?]rT。ZE
016 èASAIBn)?
?/?
′? 7′
m
?、
?a1?¤
sá
?1 e?e￥??,
?s1A、B、C、D
4F,
?F40 è:AF
?8á
???-=
3j10mg;BF
?8á
???-=
3j10mg,?e,=F?-=
3j10gm??ó0;cF?e,ˉ V=
3joImg
?aá
???ó0:DFT1vF,?
P¨-=
3j。
4F?e,0t￥1 (1
}o
tD2“
=kgF
3 ?÷
￡à10ml, ?4
,?QF4
,
í?
HW, (B
á。sY?
?a4、8、12、24、48h43i:
ch|￥??
q(RR),?
q(HR),ü (?
?a(MA)P,ó
?(SpOZ);pONV?
3
q;.e?s(VAs)￥s′。2T4FW1?R、HR、MAp、SpO:ò?·S￥
M?μsíd9Dil(P>.005);PONV?
3
q,
?aò43
H?M1:A、B、CFDDFμsμd9D
il(P<.001):B、CFDAF ?2?24h=μsμd9Dil(P<.005),BFDCF-Wμsíd
9Dil(P>.005)。2
?-=
3j
?aá
?1 e?e￥PONVμ
üA￥?]T¨,?Bá
???-
=
3j?????]
?a48h=￥0?|s,7
?aü,á
???ó0?5??D???μr￥?]
?a
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【1oM】-=
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T;á
?1 e?e;0?;glts
CliniealObservaitononAzasetroninDel】trentInfusion
ModesinPervenitngPostoPerativeNauseaandVOmiting
BaoShengxuel,W1ngaYnlinl,ZhangGuangxiongZ,etal
1DePartmentofAnesthesiology,ZhongnanHosPitaIofWuhanUnivesrity,Wuhan430071
2DePartmentofAnesthesjology,HubejHosPjtalofChjnesePeoPle’s
ArmedPolieeFocre,Wuhan430061
[bAstaret]ObjeeitveoTevaluatethedifeerntPorPhylaetieefeetsofazaseotrnindefeerntinfusion
modesonPostoPeartivenauseaandvomiting(PONV)duringPatienteontrolledintravenousanalgesia(pCIA).Me-
htodsOnehundredandsixytPatients,seheduledforseleetiveuPPerabdominaloPerations,weerrandomlydi-
videdintofourgoruPs,patientsereeivinganintarvenousbolusofaazseotrnlomg(grouPA,n=40),anintarvenous
bolusofazasetronl0mgandaeontinuedinfusionofazasetronlomginpump(gorupB,nB40),10mgofazasetron
inpumP(goruPC,n=40),noazagetron(gorupD,nB40).Respirationarets(RR),heartartes(HR),meanarterial
bIoodPressuer(MAp)andSpOZofPatientsindiferentgroupsweerreeodredat4,8,12,24,48hPostopeartively.
TheineideneesofPONVandtheVASseoersinthesametimeweerereordedtoo.eRsulstRR,HR,MAP,SPOZ
hadnosigniifeantdifeerneeinallthegrouPs.TheineideneeofPONVingrouPsA,BandCwassigniifeantly
lowerthanthatingroupD(P<0.01).TheineideneeofpONVingroupsBandCwassigniifeantlylowerthanthat
ingorupAinPostoperative24B48h(P<0.05).TherewasnosigniifeantdifeerneebetweengroupsBandC(P>
0.05).CocninsionAzasetroneanbeusedefeetivelytoPreventPONVduringPCIA.Anintarvenousbolusof
azasetron10mgeannotbeusedsuifeientlytoPreventPONVinPostoPerative24~4sh,butaeontinuedinfusion
ofazasetorn10mginPumPwithorwithoutanintarvenousbolusdoseeanbeusedsuifeientlytoPreventPONV
inPostoPeartive48h.
IK''wodsrlazasetron;difeerntinfusionmode:pCIA;nausea:vomiting
6D,3,
?
V( );C óTμ9Dy
?J SyT
(430061)
-? ?0ty?erT?M,
?aá
?1
e?e(PCIA)?|¤
?irT。?? ?0t V?
341
1 e?e0?|s(PONV)??
Q?,?á??P
-??,?Y
¤
?,
?a
g??9{ ?B??Y。
''ù??¨5Bü??á F0-=
3j,)?]
ó0Z
T
?a
}o
tDá
?1 e?e?￥?
Q?￥?Y,? 1
"5]íM1?
Q?4K
D￥ó0Z
T。
1''
DZE
LlB?''
ê44ù
m
?h|160 è,ASAI
?),
?-í?×?、k、é、
/、=s
?"d%
h,í-? ?0t
P¨ì<,íPONVh
N,?¨?
pu0。?376 è,o84 è,M
-16B72
?,8×
40B85kg,
?μh è ( ?
?/é?
′? 7′
m
?。
?s1A、B、C、D4F,
?F40 è,4FM
-、?Y、8×íA÷?μs(P>.005)。nV1。
V14Fh|B?''
Q
V:,n=40
FY。(3/o)
21?9
18/22
17/23
20/20
M
-(
?)
38?
V15.2
42.2
V13.1
40.1
V109
418
V9?
8×(?)
58.5
V12.7
587
V9.1
59.2
V11.3
61.8
V9.7
,CPBEBI,-=
3j1?~
82~0<μK
3
3
á￥÷
?-=
3j?
A。4F?e,0t￥1 (
1
}o
tD2
g(gF
3 ?÷
￡à10ml,?AF
?8á
???-=
3j10mg?a¤?e,,BFá
???-=
3j10mg#?e,=-=
3j10mg
?a??ó0,cF?e,=-=
3j10mg
?aá
???ó0,DF
?8°¤¤?e,,?
?h|
?8
b?ù"5?5a ¤á
?1 e?e,, ?4
2ml,?Q1 eF4
2ml/Q。
í?
HW40
min,???e48h。
1.343["①
?a4、8、12、24、48hò
H?
￥??
q(RR)、HR、MAp?SpOZ;②
?a4、
8、12、24、48hPONV?
3
q;③
?a4、8、12、
24、48h???erT,?QFQ
?。ò
HW?
.e?s?¨e
j $E?s(VA)S:0s1íe,
<3s1?e
?i,3B10s1?e?
?i。
1.4d9D) ??¨SPSSl.Od9sèqé
?d9Ds。9
''
[ (
?
VSμ(
、)V
U,
?¨?y
íZμs,9
?''
?¨
±_,
C<.005
1μsμd9Dil。
ABCD
1.2
?JD?eZE
?-30min?÷
?9
÷50mg,-??.05mgê
?a.03mg。?
?o
?0t?¨,???(0.1mg(g)、o
tD(5Ig)、
? o?+(0.1mg/kg)?Y?,Z(0.4mgg),
??
Wá
?óío
tD?? o??#s?
????。
m
??v
HW?é?,?à=#
í/
''á
?,
?」???á
??5。
?a?¨DaetexomdeaS?N
??S?ü (?
?a(MA)P、?
q(HR)?ó
?(Spo:)。?e,?¨BQ?
P¨è0 e??e
22T
l)
?a4Fò
H?RR、HR、MAp、spOZ ( ?
èS?,F=?FW1?μs (íd9Dil(
C>
0.05)。A、B
F?μ?sh|
?8sh=?
_
¤
?,??-?ís,RR、HR、MAP、sP? (?è。
2)4F
?a48hVAS?sl?3s,?e|¤
?irT,òFWò
HW?M1?μsíd9Di
l(
C>.005),F=4hD48h
HW?1?μsμd
9Dil(
C<.005)。nV2。
V24Fh|
?a48hVAS?s1?Q
V]
FY?]
H?
VSA?s
48122448
2. 1.1
2.1
V1.2
2.1r1.1
2.0r0.9
!.6r1.0
1.5
V0.9
1.7
V11
1.6r0.9
13
V0.8
!..08
1.4
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1.3
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1.3r0.7
1.1
V0.8
]2r07
1.1
V0.8
1.0.8
40ABCD
D4h1?,J<005
3)4F
?a?Q1 eFQ
?,òFWò
HW?
1?μsíd9Dil(
C>.005)。
4)4F
?aPONV??
Q??
3
q:A、B、C
FDDFM1μsμd9Dil(
C<0.01);B、CF
DAF
?a?2?24hM1μsμd9Dil(
C
<.005);BFDCF-WM1μsíd9Dil(P
>.005),AF
?a?2?24hD
?a4hM1μs
μd9Dil(p<.005)。nV3。
432
V34F
?aPNVO?
3
q￥1?/n(%)
FY
?a
HW()h0?
3(75)
4(10.0)
7(17.5)0
2(5.0)
2(5.0)
2(5.0)☆
3(75)
2(5,0)
2(5.0)☆
DA
8~24
?2?24
4
8~24
?2?24
4
8~24
?2?24
4
8~24
?2?24
B、CF1?,P<0
.
01;B
15(37.5)
10(25.0)
7(|7￡)
CFDAF1?
0??|s
l(2.5)
2(5.0)
5(12.5)o
l(2.5)
2(50)
1(2.5)☆
2(5.0)
2(50)
I(25)☆
8(20.0)
6(15.0)
5(12.5)
?ONV99
4(10.0)
6(]5.0)
12(30.0)o
3(75)
4(10.0)
3(7.5)☆
4(100)
4(10.0)
3(7j)☆
23(575)
15(40.0)
12(30.0)
,☆P<0.05;AF?2?24hD4h1?,OP<0.05
3)
?
}o
tD
^T¨?
ü"d￥-? ?
s8,¨
?
?aá
?1 e?eí
rT?M。?
"543
V?PONV??
Q?,?e,??¨
}o
tD
?A÷9F
?aPONV?
3
q,F×??e m+。?
T
?a?e,48h???¨,
?a?Zdˉ?μPoNv
￥?
3,Oy?Zdh|é
J V÷
.。PONV???
Y
?a?e,? V[?
??×aT:??
￡、è
3é?
y、
g
7?。"??|s?,o?PONv
í y
í?,5Bü??1oT¨2[]。1
4ú?e
é
,ù D? ùs-? ?0t￥KD?eμr
4
￥]
H,ê4 ó?¨0, F、?]?h
V
?C￥?
Q?,[r?KDrTl3[。''ù?V
ü,4F
?a?e (|¤
?irT。F=4hD48h
HW?1?μsμd9Dil(p<.005), V?
^
?
a
}o
tD 8=r?μrí
i31B?￥
H
W,748hP·8=
}o
tDX×? μr￥ó0
i,]
H??
g
3é??,.e9 B??
μ
?h^。
-? ?0tYVO?
17
i???D
s8(
?{(CTZ)?yü
Y|s?
w,?PONV,?
3
qr20%B80%4l[。-=
3j1??úê4?5BHT3
s8á F0,?á F????
w5BHT:
s8,V7E
?5BHT3
s8?￥
ù<
ü?y
?á|sQ
,
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Q?l5]。9ü
^
a
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á
?¨0 ó?¨0
H,-? ?0tü
Y au
bs?D?
suμ?yT¨,7-=
3j￥?
w
ü? F?ar?h
-?y,]?
ù<
ü??,E
ü
Y?D?
s￥(?u7?|T¨。''ù?
A
U,-=
3j
?aá
?1 e?e?￥PONVμ
üA￥?]T¨,
LFDvF1?μsμA÷
?(p<.001)。"-,??PONv￥?o?
^| F|
s0?-? ?0]
H[PCIAó06[J,''ù?A
U,
?8?Bá
???-=
3j????μr?]
?a
48h=￥0?|s,D??-=
3jF,=??ó
0D,=??ó0
?M1
?a?2?24hμsμ
A÷??<0.05)。BZ
?,??}??ey,-=
3j￥ó0i
?"
HW￥wM7/?;
6BZ
?,
?a?Zd?s?? 7
Sé
J,
PPONV￥?
3
q9
v。
?aü,á
???ó0?5??D???μr
￥?]
?a48h=￥PONV,V
ü-=
3jD
}o
tD]
H[PCIAó0,;?erT?M,??μr
￥?]
?a￥PONV。''ù?μ?sh|?
_
¤
?, V?D-=
3j μ?áT¨μ1。
? IóD
1]P
,?D, ù?,?.2861 è?
?
?a|s?
3
qs.
"5
?JD?,1995,B4(4):300
2KovaCAL
.Pr
eventionandtreatmentofPostPerative
nauscaandvomiting:Drugs,2000,59(12):213
3?§?,fò,ák￡
.
1?
ü
?h
m
?a??
?e
?e?￥0?|s.
"5
?JD?,201,17(5):254
4fó/.
?ah|1 e?eD0?|s.S?DD
?JDD
ˉ
ês¨,1999,20(2):59
5EmstE,PittlerMH.Eifeaeyofgingerofrnauseaand
vomiting:asystematiereviewofrandomizedelinieal
trials.BrJAnaesth,2000,84(16):367
6±S?,§b?
.5B
HT3
s8D
?a0?|s￥M1?.S
?DD
?JDDˉ
ês¨,1995,16(3):F8
(2006B09B02
là)
(I:
gZb)
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