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儿童恶心和呕吐的管理

Management of nausea and vomiting in children.

作者信息

Keller V E

机构信息

Indiana University School of Nursing, Indianapolis 46202, USA.

出版信息

J Pediatr Nurs. 1995 Oct;10(5):280-6. doi: 10.1016/S0882-5963(05)80045-4.

Abstract

When children experience nausea and vomiting (N/V) as side effects of anesthesia or chemotherapy, a major role for nurses is to promote comfort. In addition to the discomfort of N/V in children, other detrimental effects include dehydration, weight loss, fluid and electrolyte imbalance, and emotional distress. This article describes the physiological pathways through which the vomiting center is stimulated to cause nausea and vomiting and identifies appropriate interventions for blocking these pathways using both pharmacological and nonpharmacological means. Medications used to control nausea and vomiting, including phenothiazines, substituted benzamide, corticosteroids, benzodiazepines, antihistamines, and serotonin antagonists, are discussed. Nonpharmacological interventions that are described include reducing anxiety, music therapy, hypnosis, progressive muscle relaxation, dietary modifications, and acupressure.

摘要

当儿童因麻醉或化疗出现恶心和呕吐(N/V)等副作用时,护士的主要职责是促进患儿舒适。除了N/V给儿童带来的不适外,其他有害影响还包括脱水、体重减轻、液体和电解质失衡以及情绪困扰。本文描述了刺激呕吐中枢引发恶心和呕吐的生理途径,并确定了使用药物和非药物手段阻断这些途径的适当干预措施。文中讨论了用于控制恶心和呕吐的药物,包括吩噻嗪类、取代苯甲酰胺类、皮质类固醇、苯二氮䓬类、抗组胺药和5-羟色胺拮抗剂。所述的非药物干预措施包括减轻焦虑、音乐疗法、催眠、渐进性肌肉松弛、饮食调整和指压疗法。

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