摘要
目的探讨腹腔镜胆囊切除术(LC)后发生恶心呕吐(PONV)的相关危险因素,为改善患者预后、提高术后生活质量提供参考。方法选取2014—2015年四川省宜宾市第二人民医院收治的因胆囊良性疾病行LC的320例患者,根据其是否发生PONV分为PONV组和对照组,收集患者一般资料和相关可能危险因素。采用多因素Logistic回归分析LC后发生PONV的相关危险因素。结果 320例患者均顺利完成LC,PONV发生率为58.13%(186/320),其中101例(31.56%)发生于术后6h内。PONV组和对照组性别、体质指数(BMI)、手术时间、自主呼吸恢复时间、麻醉复苏时间、术中留置胃管、术中气腹压、术后使用阿片类药物、术后疼痛、吸烟史、术前焦虑、晕动病史比较,差异均有统计学意义(P<0.05)。多因素Logistic回归分析显示,女性(OR=2.910)、自主呼吸恢复时间长(OR=4.419)、术中气腹压≥14mm Hg(OR=3.394)、不吸烟(OR=0.443)、有晕动病史(OR=3.377)是LC后发生PONV的独立危险因素(P<0.05)。结论女性、自主呼吸恢复时间长、术中气腹压≥14mm Hg、不吸烟、有晕动病史是LC后发生PONV的独立危险因素。积极干预可控危险因素,将有助于预防PONV的发生。
Objective To analyze the influencing factors of postoperative nausea and vomiting（ PONV） after laparoscopic cholecystectomy（ LC）,and to provide reference for improving the prognosis and improving the quality of life in the patients. Methods 320 cases with benign gallbladder disease undergoing LC operation were collected from the Second People’s Hospital of Yibin from 2014 to 2015,and they were divided into PONV group and control group according to whether occured PONV. The genera data and possible risk factors in all the patients were collected. Multivariate Logistic regression model was used to analyze the risk factors of PONV after LC. Results LC operation was successfully performed in 320 patients, and the incidence of PONV was 58. 13%（ 186/320）, and 101 cases（ 31. 56%） occurred in postoperative 6 h. The gender, BMI,operation time, spontaneous breathing recovery time, anesthesia recovery time, intraoperation stay tube, pneumoperitoneum pressure,postoperative use of opioid drugs,postoperative pain,smoking history,preoperative anxiety, halo dynamic history were significant difference between PONV group and control group（ P 〈 0. 05）. Multivariate Logistic regression analysis showed that women（ OR = 2. 910） and respiration recovery time long（ OR = 4. 419）,pneumoperitoneum pressure ≥14 mm Hg（ OR =3. 394）,not smoking（ OR = 0. 443）, and history of motion sickness（ OR = 3. 377） were independent risk factors for the occurrence of PONV after LC（ P 〈 0. 05）. Conclusion Women, spontaneous breathing recovery time long,pneumoperitoneum pressure greater than or equal to 14 mm Hg,not smoking,history of motion sickness are the independent risk factors of PONV after LC. Active intervention of controllable risk factors will help to prevent the occurrence of PONV.
出处
《实用心脑肺血管病杂志》
2016年第B12期122-124,共3页
Practical Journal of Cardiac Cerebral Pneumal and Vascular Disease
关键词
胆囊切除术
腹腔镜
手术后恶心呕吐
危险因素
病例对照研究
Cholecystectomy,laparoscopic
Postoperative nausea and vomiting
Risk factors
Case-control studies
