接受腹腔镜胃肠道手术的女性患者术后恶心呕吐的双重预防疗法

Pub Date : 2024-06-03 eCollection Date: 2024-04-01 DOI:10.1055/s-0044-1787305
Chunmeng Lin, Jing Li, Qian Wu, Tongfeng Luo, Zhinan Zheng
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摘要

目的 术后恶心和呕吐(PONV)是手术后的一个主要问题。本研究旨在说明在双重预防性治疗的背景下,接受腹腔镜胃肠道手术的女性患者 PONV 的发生率及其潜在的相关因素。方法 我们的回顾性研究从 2020 年 10 月至 2021 年 3 月在中国广州中山大学附属第六医院招募了 109 名接受腹腔镜胃肠道手术的女性患者,她们接受了帕洛诺司琼与地塞米松联合的双重预防性治疗。对患者特征和围手术期管理因素进行单变量和多变量分析,以确定影响PONV的因素。结果 有四名患者没有完整的病历,在纳入最终分析的 105 名患者中,有 53 名患者(50.5%)出现了 PONV。确定了两个影响 PONV 的因素:化疗史(几率比 [OR] 0.325,95% 置信区间 [CI] 0.123-0.856;P = 0.023)和氢吗啡酮用量≥ 0.02 mg/kg(OR 2.857,95% CI 1.247-6.550;P = 0.013)。通过分析接收者操作特征曲线评估了多变量逻辑回归的性能,结果曲线下面积值为 0.673。结论 在接受腹腔镜胃肠道手术的女性患者中,即使采取了双重预防治疗,PONV 的发生率仍然很高。氢吗啡酮剂量≥ 0.02 mg/kg 可能会增加 PONV 的风险,而化疗史可能是一个保护因素。
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Postoperative Nausea and Vomiting in Female Patients Undergoing Laparoscopic Gastrointestinal Surgery with Double Prophylactic Therapy.

Purpose  Postoperative nausea and vomiting (PONV) is a major problem after surgery. This study aimed to demonstrate the incidence of PONV and the potential associated factors in female patients undergoing laparoscopic gastrointestinal surgery against the background of double prophylactic therapy. Methods  Our retrospective study recruited 109 female patients undergoing laparoscopic gastrointestinal surgery with double prophylactic therapy, combining palonosetron with dexamethasone, from October 2020 to March 2021, at the Sixth Affiliated Hospital of Sun Yat-sen University, Guangzhou, China. Patient characteristics and perioperative management factors were included in univariate and multivariate analyses to identify factors influencing PONV. Results  Four patients lacked complete records, and of the 105 patients included in the final analysis, 53 (50.5%) patients developed PONV. Two influencing factors for PONV were identified: a history of chemotherapy (odds ratio [OR] 0.325, 95% confidence interval [CI] 0.123-0.856; p  = 0.023) and dosage of hydromorphone ≥ 0.02 mg/kg (OR 2.857, 95% CI 1.247-6.550; p  = 0.013). The performance of the multivariate logistic regression was evaluated by analyzing receiver operating characteristic curves, resulting in an area under the curve value of 0.673. Conclusion  The incidence of PONV remains high in female patients undergoing laparoscopic gastrointestinal surgery, even with double prophylactic therapy. A dosage of hydromorphone ≥ 0.02 mg/kg may increase risk of PONV, whereas a history of chemotherapy might be a protective factor.

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