成年患者神经外科手术麻醉恢复期恶心呕吐的情况分析

Incidence of postoperative nausea and vomiting following neurosurgical procedures in postanesthesia care unit

目的通过回顾性分析，探讨不同神经外科手术成年患者麻醉恢复期恶心呕吐的发生情况。方法2009年5月至2011年3月麻醉恢复室（PACU）收治的神经外科术后成年患者5078例，按肿瘤部位和手术种类分组。观察并记录患者恶心呕吐的发生情况。结果5078例患者中，发生术后恶心呕吐798例，发生率为15．7％。其中颅咽管瘤组占28．4％（25／88）、脑室肿瘤组26．7％（35／131）、后颅窝肿瘤组24．2％（157／650）、脑血管病组20．8％（87／418）、幕上肿瘤组19．3％（297／1535）、癫痫组15．8％（16／101）、经蝶窦垂体瘤组8．9％（88／991）、脊髓肿瘤组8．4％（52／619）及其他手术组7．5％（41／545）。结论神经外科不同部位手术患者术后恶心呕吐的发生情况不同，需针对不同的病种严密观察及时处理。

Objective To study the incidence of postoperative nausea and vomiting （PONV） after different neurosurgical procedures in the postanesthesia care unit （PACU）. Methods 5 078 adult patients who had undergone neurosurgical procedures enrolled into PACU were divided nine groups. The incidence of PONV were recorded and treated. Results The overall incidence of PONV following neurosurgical procedures was 15.7% . The incidence of PONV in patients undergoing craniopharyngioma, ventricular tumor ~infratentorial craniotomy ~intracranial aneurysm and arteriovenous malformation^supratentorial tumor, epilepsy,transsphenoidal surgery of pituitary tumor, spinal cord tumor and others was 28.4% ,26. 7%, 24. 2% ,20. 8%, 19.3%, 15.8%, 8.9%, 8.4% and 7. 5%, respectively. Conclusions The overall incidence of PONV in PACU following neurosurgical procedures is approximately 16%. The incidence of PONV following neurusurgical procedures is different and craniopharyngioma,ventricular tumor and posterior fossa tumor are high risk factors for PONV. Strategies for the prevention of PONV following neurusurgical procedures are required.