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目的 观察帕洛诺司琼对腹腔镜低位保肛直肠癌根治结合缓释型氟尿嘧啶植入术后恶心呕吐的有效性与安全性.方法 进展期直肠癌患者200例, 随机分为帕洛诺司琼组和托烷司琼组, 每组100例.两组均接受腹腔镜低位保肛直肠癌根治术结合缓释型氟尿嘧啶植入综合治疗, 帕洛诺司琼组和托烷司琼组在综合治疗前30 min分别予帕洛诺司琼0.25 mg iv和托烷司琼5 mg iv.记录两组患者术后3 d内的恶心呕吐发生情况, 观察不良反应的发生情况.结果 术后第1日, 帕洛诺司琼组和托烷司琼组恶心的发生率分别为31％和46％, 术后3 d内分别为31％和48％, 两组相比有显著差异 (P ＜0.05) .两组术后第2日的恶心发生率和各时间点的呕吐发生率均无显著差异 (P＞ 0.05) .两组头痛、便秘、腹胀的发生率无显著差异 (P＞ 0.05), 帕洛诺司琼组眩晕的发生率低于托烷司琼组 (7％vs. 17％, P ＜0.05) .结论 帕洛诺司琼预防腹腔镜低位保肛直肠癌根治术结合缓释型氟尿嘧啶植入综合治疗后所致恶心的效果优于托烷司琼, 且安全.“,”AIM To observe the efficacy and safety of palonosetron in the treatment of nausea and vomiting after laparoscopic radical operation combined with sustained-release fluorouracil implantation for low anus-preserving rectal cancer. METHODS A total of 200 patients with advanced rectal cancer were randomly divided into palonosetron group and tropisetron group, 100 cases in each group. Both groups were treated with laparoscopic radical resection of low anus-preserving rectal cancer combined with sustained-release fluorouracil implantation. The patients in the palonosetron group were treated with palonosetron (0.25 mg, iv) 30 min before operation, while the tropisetron group were treated with tropisetron (5 mg, iv) at the same time. The occurrence of nausea and vomiting within 3 days after operation was recorded, and the occurrence of adverse reactions was observed. RESULTS The incidence of nausea in the palonosetron group and the tropisetron group was (31％ vs. 46％) and (31％ vs. 48％) at the first day and within 3 days after operation. The preventive of nausea in the palonosetron group was significantly better than that in the tropisetron group (P ＜ 0.05). There was no significant difference in the incidence of nausea and vomiting between the two groups at the second day (P＞ 0.05). There was no significant difference in adverse reactions of headache, constipation and abdominal distension between the two groups (P＞ 0.05), but the incidence of vertigo in the palonosetron group was lower than that in the tropisetron group (7％ vs. 17％, P ＜ 0.05). CONCLUSION Palonosetron is superior to tropisetron in terms of preventing nausea after laparoscopic radical operation for low anus-preserving rectal cancer combined with sustained-release fluorouracil implantation, and it is safety.