首页|微血管减压术患者发生术后恶心呕吐的影响因素分析

微血管减压术患者发生术后恶心呕吐的影响因素分析

扫码查看
原文链接
  • NETL
  • NSTL
  • 万方数据
目的 探讨微血管减压术(microvascular decompression,MVD)患者发生术后恶心呕吐(postoperative nausea and vomiting,PONV)的影响因素.方法 选取2022年1月4日至2023年3月25日首都医科大学宣武医院行MVD的患者385例.根据术后24 h内是否发生PONV分为PONV组(203例)和非PONV组(182例).采用多因素logistic回归分析MVD患者发生PONV的影响因素.结果 385例患者中男164例,女221例,年龄24～80岁,平均(56.3±11.0)岁;其中面肌痉挛148例,三叉神经痛237例.术后24 h内发生PONV 203例,发生率为52.73%.多因素logistic回归分析结果显示,无吸烟史(OR = 0.290,95%CI:0.161～0.521,P = 0.000)、血管与神经粘连(OR = 2.381,95%CI:1.115～5.084,P = 0.040)、责任血管数量越多(OR = 2.426,95%CI:1.132～5.198,P = 0.023)、垫片数量越多(OR = 1.665,95%CI:1.187～2.335,P = 0.003)、麻醉时间越长(OR = 1.006,95%CI:1.001～1.012,P = 0.031)、未预防使用止吐剂(OR = 0.535,95%CI:0.300～0.953,P = 0.034)、使用七氟烷(OR = 33.315,95%CI:14.102～78.707,P = 0.000)、术后镇痛泵舒芬太尼使用量越多(OR = 1.029,95%CI:1.010～1.049,P = 0.003)的患者术后更容易发生PONV.结论 MVD患者PONV发病率较高,手术操作、患者本身因素、术中麻醉及术后镇痛等因素均可导致PONV的发生.在MVD手术时长一定的情况下,对于术中血管与神经粘连、责任血管数量多的患者预防性使用止吐剂、减少术中吸入类麻醉药物使用、术后采用多模式镇痛以减少阿片类药物的使用量,能够有针对性的预防PONV的发生.
Analysis of influencing factors of postoperative nausea and vomiting in patients undergoing microvascular decompression
Objective To explore the influencing factors of postoperative nausea and vomiting(PONV)in patients undergoing after microvascular decompression(MVD).Methods A total of 385 patients who underwent MVD in Xuanwu Hospital of Capital Medical University from January 4,2022 to March 25,2023 were selected,and were devided into PONV group(203 cases)and non-PONV group(182 cases)according to whether PONV occurred within 24 hours after operation.The influencing factors of PONV in MVD patients was analyzed by multivariate logistic regression.Results Among the 385 patients,there were 164 males and 221 females,aged from 24 to 80 years,with an average age of(56.3±11.0)years.There were 148 cases of facial spasm and 237 cases of trigeminal neuralgia.A total of 203 of PONV occurred within 24 hours after operation,the incidence rate was 52.73%.Multivariate logistic regression analysis showed that patients with no smoking history(OR = 0.290,95%CI:0.161-0.521,P = 0.000),vascular and nerve adhesions(OR = 2.381,95%CI:1.115-5.084,P = 0.040),more responsible blood vessels(OR = 2.426,95%CI:1.132-5.198,P = 0.023),more pads used(OR = 1.665,95%CI:1.187-2.335,P = 0.003),and longer anesthesia time(OR = 1.006,95%CI:1.001-1.012,P = 0.031),without prophylactic use of antiemetics(OR = 0.535,95%CI:0.300-0.953,P = 0.034),the use of sevoflurane(OR = 33.315,95%CI:14.102-78.707,P = 0.000),the higher the amount of postoperative analgesic sufentanil used(OR = 1.029,95%CI:1.010-1.049,P = 0.003),were more prone to have PONV.Conclusions The incidence of PONV in MVD patients is high,and surgical operation,patients'own factors,intraoperative anesthesia and postoperative analgesia can all lead to PONV.In the case of a certain duration of MVD surgery,preventive use of antiemetics,reducing the use of inhaled narcotic drugs during the operation and reducing the use of opioids after the operation can prevent the occurrence of PONV.

microvascular decompression(MVD)postoperative nausea and vomiting(PONV)influencing factors

李博然、马艳辉、王天龙

展开 >

100053 北京,首都医科大学宣武医院麻醉手术科

微血管减压术 术后恶心呕吐 影响因素

北京市医院管理局临床医学发展专项

ZYLX201818

2024

10.15932/j.0253-9713.2024.02.006

北京医学
中华医学会北京分会

北京医学

CSTPCD
影响因子：0.714
ISSN：0253-9713
年,卷(期)：2024.46(2)
  • 15