腹腔镜结直肠癌根治术昂丹司琼与地塞米松 联合用药对改善术后恶心呕吐的效果分析

Analysis of the Effect of Combined Use of Ondansetron and Dexamethasone in Improving Postoperative Nausea and Vomiting after Laparoscopic Radical Resection for Colorectal Cancer

摘要: 目的：探讨全身麻醉腹腔镜结直肠癌根治术中联合应用昂丹司琼及地塞米松对预防术后恶心呕吐的改善效果，为临床制定更有效的防治方案提供参考。方法：选取2022年12月1日~2024年11月9日收治的60例腹腔镜结直肠癌根治手术患者，随机分为试验组和对照组各30例。对照组采用常规护理及手术结束前半小时生理盐水静脉注射；试验组在对照组基础上实施联合昂丹司琼及地塞米松静脉注射。比较两组术后恶心呕吐发生情况、严重程度、康复指标。结果：试验组术后24小时、48小时、72小时恶心呕吐发生率分别为16.67%、10.00%、3.33%，显著低于对照组的40.00%、33.33%、26.67%；首次排气时间、首次下床活动时间及住院天数均短于对照组，差异均有统计学意义(P < 0.05)。结论：全身麻醉结直肠癌根治术在手术结束前半小时联合昂丹司琼及地塞米松能显著降低术后恶心呕吐发生率，减轻症状严重程度，促进患者术后康复，符合美国日间/门诊麻醉学会(SAMBA)术后恶心呕吐(PONV)管理共识指南要求，具有临床应用价值。

Abstract: Objective: To investigate the effect of combined application of ondansetron and dexamethasone under general anesthesia in laparoscopic radical surgery for colorectal cancer on improving postoperative nausea and vomiting, providing a reference for developing more effective clinical prevention and treatment strategies. Methods: Sixty patients undergoing laparoscopic radical surgery for colorectal cancer admitted from December 1, 2022, to November 9, 2024, were selected and randomly divided into an experimental group and a control group, with 30 cases in each group. The control group received routine care and intravenous injection of normal saline half an hour before the end of surgery; the experimental group received combined intravenous injection of ondansetron and dexamethasone in addition to the control group’s regimen. The incidence, severity, and recovery indicators of postoperative nausea and vomiting were compared between the two groups. Results: The incidence of nausea and vomiting in the experimental group at 24 hours, 48 hours, and 72 hours postoperatively was 16.67%, 10.00%, and 3.33%, respectively, significantly lower than that in the control group (40.00%, 33.33%, and 26.67%). The time to first flatus, time to first ambulation, and length of hospital stay were shorter in the experimental group than in the control group, and the differences were statistically significant (P < 0.05). Conclusion: The combined use of ondansetron and dexamethasone half an hour before the end of radical resection of colorectal cancer under general anesthesia can significantly reduce the incidence of postoperative nausea and vomiting, alleviate the severity of symptoms, and promote postoperative recovery of patients. It meets the requirements of the Society for Ambulatory Anesthesia (SAMBA) consensus guidelines for the management of postoperative nausea and vomiting (PONV) and has clinical application value.