基于倾向性评分匹配法探讨氯胺酮对剖宫产患者术后瘙痒的影响

Effect of Ketamine on Postoperative Pruritus in Cesarean Section Patients Based on Propensity Score Matching Method

目的:应用倾向性评分匹配法探讨术中静脉注射氯胺酮对剖宫产患者术后瘙痒的影响。方法:收集2019年6月~2019年12月在某院硬膜外麻醉下进行剖宫产手术患者的资料,根据术中是否静脉注射氯胺酮分为2组,氯胺酮(K组)及对照组(C组),应用倾向性评分匹配法分析两组患者术后瘙痒发生情况,评价氯胺酮对术后瘙痒的影响。结果:共有510例患者符合纳入标准,对照组372例,氯胺酮组138例。在倾向性评分匹配前,两组患者基础资料许多变量(如年龄、体重、血压等)差异均存在统计学意义。通过使用倾向性评分匹配方法,C组118例患者与K组118例患者配对成功,两组各变量差异无统计学意义(P>0.05);通过使用倾向性评分匹配后的队列分析显示,K组有13例患者出现了术后瘙痒(占11.1%),主要为轻中度瘙痒;C组有41例患者出现了术后瘙痒(占34.7%),除轻中度瘙痒患者外,尚有14.6%的重度和极重度患者。两组差异有统计学意义(P<0.05)。结论:围术期静脉注射氯胺酮可以降低剖宫产患者术后瘙痒的发生率及瘙痒程度。

Objective:To investigate the effect of intraoperative intravenous ketamine on postoperative pruritus in cesarean section patients by propensity score matching method.Methods:The data of patients undergoing cesarean section under epidural anesthesia in a hospital from June 2019 to December 2019 was collected.According to whether intravenous ketamine was injected intravenously during the operation,all patients were divided into ketamine group(group K)and control group(group C).The propensity score matching method was used to analyze the incidence of postoperative pruritus in the two groups and evaluate the effect of ketamine on the postoperative pruritus.Results:A total of 510 patients met the inclusion criteria,including 372 in the control group and 138 in the ketamine group.Before the propensity score matching,the differences in many variables(such as age,weight,blood pressure,etc.)of the basic data of the two groups were statistically significant.By using the propensity score matching method,118 patients in group C and 118 patients in group K were successfully matched,and there was no statistically significant difference in variables between the two groups(P>0.05).A cohort analysis using propensity score matching showed that 13 patients in group K developed postoperative pruritus(11.1%),mainly mild to moderate itching.41 patients in group C developed postoperative pruritus(34.7%),in addition to mild to moderate pruritus,there were 14.6%of severe and extremely severe patients.The difference between the two groups was statistically sig nificant ( P <0.05). Conclusion: Perioperative intravenous injection of ketamine can reduce the incidence of postoperative pruritus and degree of pruritus in cesarean section patients.