术后恶心呕吐是手术后常见的并发症,也是影响患者术后恢复的重要因素之一。术后恶心呕吐的防治主要分为药物治疗和非药物治疗。由于尚未出现可以完全防治术后恶心呕吐的单一有效手段,因此需要通过联合各种药物及非药物的治疗方法,来改善术后恶心呕吐及减少不良反应,即多模式镇吐。文中新一代抗恶心呕吐药物的出现、防治术后恶心呕吐辅助用药和非药物疗法的更新,为多模式镇吐和加速康复外科提供了更多的选择,优化了治疗效果,减少了相关的不良反应。
Postoperative nausea and vomiting is a common complication and an important factor affecting the recovery of patients after operation. The prevention and treatment of postoperative nausea and vomiting is mainly divided into drug treatment and non-drug treatment. Since there is no single effective method to prevent and cure post-operative nausea and vomiting, it is necessary to use multimodal antiemetic which combines various drug and non-drug therapies to optimize the treatment effect and reduce the related adverse reactions. The emergence of a new generation of anti-nausea and vomiting drugs, the updating of adjuvant drugs and non-drug therapies provide more choices for multimodal antiemetic and enhanced recovery after surgery.
术后恶心呕吐,防治,多模式镇吐, Postoperative Nausea and Vomiting Prevention and Treatment Multimodal Antiemetic成人术后恶心呕吐的防治进展
① 丁酰苯类:氟哌利多防治PONV的有效剂量为0.625至1.25 mg,手术结束时给予最为有效。最近的meta分析显示成人预防性给予小剂量氟哌利多,抗恶心呕吐效果好,并且不良反应风险低。氟哌利多可能引起QT间期延长,受到美国FDA的“黑盒子”(black box)警告,在原有QT间期延长或有心脏复极化障碍的病人,使用宜谨慎,剂量不宜超过1.25~2.5 mg∙d−1。
张 莉,张 咪,张咸伟. 成人术后恶心呕吐的防治进展 Progress in Prevention and Treatment of Postoperative Nausea and Vomiting in Adults[J]. 临床医学进展, 2019, 09(04): 456-463. https://doi.org/10.12677/ACM.2019.94071
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