nausea ?????????,????????? vomiting

1
?????????????
???????? ??????????? ???
2
???????postoperative nausea and vomiting,PONV
nausea?????????,?????????vomiting ??????????????
?,?????
3
???
PONV??????????? Cohen???320733????
PONV?????2080?? ??60??,???????????????24h?
PONV????36 20??90????,161?????????
????,?????100????PONV
4
Orkin????
???????????
??3/4??????PONV????????,?1????????, ?2?????
5
PONV
?????
?????
?????
??????
6
?????
???????
????????? ?????? ??????? ??????????????????
??????????
7
????60,????30 ?????????????????
????
???? ????
PONV
8
Morris ??PONV????????
??????? ??????(1861min) ????????
???????? US day care
centre,annual cost 25151?????????
???2?????(16)
9
?????? ???PONV?????????????????
??????PONV????????
10
????
?????
15-20???
????

?????? ????0
????
11
??????? ?????? ????????? ????????? ????????
12
Palazzo and Evans,?????24hPONV??????????
?????? ??PONV????() ??

1 ??,???????? 5.6 ??
6.7 ??,??PONV?
25.7 ??,????????
40.3 ??,??PONV?????????? 59.3 ??,??PONV???????
??? 76.4
13
????
?????
?????? ???,???
???? ????
?????
?????
???? ????
??
???CRTZ ????????
??????
???? ????
?????
???????????? ??????,???,????, ?????,???,???
???????? ???????
??,??,??,??,? ??,??,?????
14
??????
???? ?? ??? ?????? ???? 5-???
15

??????PONV
????
????
??? ??70
?????? ??????
16

???? ????
????? ?? ?? ???? ????? ?? ??????
17
?????
??
??PONV??????????? Cohen??50???70????????1.36??
PONV??????? Vance12??????????2?(3918)
Rowley,Brown3????2030,3?-12??4251
18
?????
??
???PONV??????? ???????????? ???????????????????
????? ??? PONV?????????? Cohen???????Palazzo?Ev
ans????????? ????????,?????????????????
19
?????
????
??? Palazzo?Evans???????????????? ?????????? ???
Quinn???????????????????,? ???????????????????????
?
20
?????
??
????????????PONV(24?)?????????????????
21
?????PONV??
Honkavaara ????????????????Beattie
?????PONV??????????4?,???? ????254?,PONV?????Co
burn ??????????????????????
22
?????
??????
??????????PONV???????????
??PONV
2?
?PONV?? (13.5)
??PONV??(6.7)

8?
??????? (59.3)

23
?????
??????
??PONV
25?
?PONV?? (25.0)
??PONV??(1.0)

76?
??????? (76.0)
24
????
????PONV ??????? ????? ???? ?? ?? ?????
25
????
???? ???????? ???????? ????????
26
????
PONV?????????????? ???? ?????? ???? ????????
27
????
????????? 4.3
?? ?????????1342
?????80mmHg ??PONV ????
??????????
????????? 4.3
?? ?????????1342
?????80mmHg ??PONV ????
??????????
??
??
100??,???
100??,???
28
????
??PONV???????????
PONV??????3?
?????????
10mg???????

????????
???
29
??????
???? ???? ????PONV ??? ???
??PONV??? Martin ???????(18)
?????????????(34) Borgeat ???????????????,?????
PONV(???? ???8135),???30??????????(28)
30
?????
??,??? ?????????????PONV ???,???,??,???,???
PONV??????,??? ???? ????PONV,????????????????
????????????,?????PONV??????
??????????,???????,?? ????,?????
????
31
???????
??????PONV??? ?????????????PONV
32
????
??????,PONV?????????
????
????
???PONV
33
PONV?????
?????5060 ?????4050 ??????67 ???????67 ???
??63????????4080 ??????????3676
34
????
???,???,??????PONV?? ?????????????????? ???????
?????PONV????? ???????????PONV?????
35
??PONV?????
36
??PONV?????
??? ??PONV???,????100????? PONV?????????????? A
driani??? ????????3.5,???????????? ??????????????
?????,??? ?PONV??,???????
37
???
??????PONV30??
????????????????? ??CRTZ??????,???????????
?????????? ???????3-4?? ??????????????? ??????????
???
38
??????
?????????????????,???? ???????????????5?????
???????? ????????????? ????????????4??
???????????????????,??? ????????????????????
39
??????
?????????
????????????? ??????????????? ???????2??,?????????
???? ?????????,?????????????? ????????????
40
????
???????? ?????????????????????????????????????,??
??QT??????????????? 2001?12?5?,FDA???????????????
?????????????????????????????????????????,??12???
EKG????????QT????????????????3??? ?????,?????????
????????1/10,???????????,??????????????
41
??????
????????????? ????????????? ??????????? ??????????
? ???? ?????????? ?PONV???????? ???????????? ????
??????,???????????
42
?????
???(cyclizine) ???PONV?? ?????????,????????????
43
5???3???
????????(ondansetron)
??????????? ???????3?? ???????????????????
??????? ???????????????
44
?????????(ondansetron)
??,?????????????4mg-8mg,????????50µg/kg
-100µg/kg? ??????????4mg???????,??????????????,???
? ???5-???????????(dolasetron)?????(granisetron
)?????(tropisetron) ?????????,??5-HT3????????
?????,?????????????????????????
45
???
???????????? ???????????????????
??????? ??????????????????? ???????
46
??????
?????????????
??????PONV,???????4mg-5mg,???????150ug/kg,????????
???24???????PONV????? ????????????????,??????????
???1-2???????,???????????????????????
47
Thank you!