摘要目的 评价不同容量治疗方案对患儿日间手术后恶心呕吐(PONV)的影响.方法 选择日间疝气或鞘膜积液手术患儿160例,ASA分级Ⅰ或Ⅱ级,年龄3～7岁,体重14～ 24 kg,BMI＜30kg/m2,采用随机数字表法将其分为2组(n=80):Ⅰ组静脉输注醋酸钠林格液10ml·kg-1 ·h-1,Ⅱ组静脉输注醋酸钠林格液30ml·kg-1 ·h-1.术后口服布洛芬20 mg/kg维持疼痛行为评估量表评分≤4分.记录术后24 h内PONV和口渴的发生情况、止吐药的使用情况.记录首次PONV发生时间、首次口渴时间和家属满意度评分.结果 与Ⅰ组比较,Ⅱ组PONV和口渴的发生率降低,首次使用止吐药的时间和首次口渴时间延长,家属满意度评分升高(P＜0.05),止吐药使用率差异无统计学意义(P＞0.05).结论 与静脉输注10 ml·kg-1·h-1液体比较,静脉输注30 ml·kg-1·h-1液体可降低患儿日间手术PONV的发生.

abstractsObjective To evaluate the effects of different fluid therapy protocols on postoperative nausea and vomiting (PONV) in pediatric patients undergoing ambulatory surgery.Methods A total of 160 pediatric patients,of American Society of Anesthesiologists physical status Ⅰ or Ⅱ,aged 3-7 yr,weighing 14-24 kg,with body mass index ＜30 kg/m2,undergoing elective lower abdominal ambulatory surgery,were randomized into Ⅰ and Ⅱ groups (n=80 each) using a random number table method.Lactated Ringer's solution 10 ml · kg-1 · h-1 and 30 ml · kg-1 · h-1 were intravenously infused in group Ⅰ and group Ⅱ,respectively.Ibuprofen 20 mg/kg was given orally after operation to maintain Face Legs Activity Cry Consolability score ＜4.The development of PONV and thirst and requirement for antiemetics was recorded within 24 h postoperatively.The time of first PONV,time of first thirst and score for satisfaction of family members were also recorded.Results Compared with group Ⅰ,the incidence of PONV and thirst was significantly decreased,the time of first requirement for antiemetics and time of first thirst were prolonged,and the score for satisfaction of family members was increased (P＜ 0.05),and no significant change was found in the requirement for antiemetics in group Ⅱ (P＞0.05).Conclusion Intravenously infusing fluid 30 ml · kg-1 · h-1 can decrease the occurrence of PONV when compared with intravenously infusing fluid 10 ml · kg-1 · h-1 in pediatric patients undergoing ambulatory surgery.