妇科腹腔镜手术术后恶心呕吐的临床研究

目的 分析妇科腹腔镜手术术后恶心呕吐(PONV)的发生情况及其影响因素.方法 按前瞻性临床队列研究设计,应用单因素和多因素logistic回归分析围术期变量与术后PONV发生之间的关系.术后6 h及24 h内发生的恶心或呕吐为本研究的结局变量.结果 研究期间共有260例患者行妇科腹腔镜手术,最终有237例有效病例.其中术后6 h内有80例出现PONV,术后24 h内有94例发生PONV.多因素logistic回归分析提示妇科腹腔镜手术术后6 h及24 h PONV的危险因素为既往FONV史及术毕疼痛,而氟哌利多有助于减轻术后6 h内PONV.结论 妇科腹腔镜手术PONV,高发,尤以6 h内明显;既往PONV史及术毕疼痛可增加本次手术PONV发生的风险.

Clinical analysis of postoperative nausea and vomiting following gynecologic laparoscopic procedures

Objective To analyze the incidence and influential factors of postoperative nausea and vomiting(PONV)following gynecologic laparoscopic procedures.Methods Qualified cases were collected according to prospective clinic cohort design.Univariate analysis and multivariate logistic regression were applied to examine the relations between perioperative variables and PONV.Outcome variables were the development of FONV within 6 h and 24 h following gynecologic laparoscopic procedures.Results There were 260 patients underwent gynecologic laparoscopic procedures in study period and 237 qualified cases were entered into analysis eventually.Eighty patients developed PONV within 6 h following surgery while nighty-four within 24 h following surgery.Multivariate logistic regression identified previous history of PONV and postoperative pain as the risk factors for PONV in 6 h and 24 h,while droperidol was defined as a protective factor for PONV in 6 h. Conclusion Gynecologic laparoscopic procedures has a high incidence of PONV,especially within 6 h following surgery,Both previous history of PONV and postoperative pain increase the risk of PONV.