女性手术患者全静脉麻醉术后恶心呕吐的影响因素分析

Analysis of the Influencing Factors of Postoperative Nausea and Vomiting in Female Surgical Patients under Total Intravenous Anesthesia

目的:分析女性手术患者全静脉麻醉术后恶心呕吐(PONV)的影响因素。方法:回顾性分析2021年1月—2022年4月于广州中医药大学深圳医院麻醉科实施全静脉麻醉女性患者3532例的临床基本资料,应用PONV评分将3532例患者分为PONV组(n=1055,PONV>2分)与对照组(n=2477,PONV≤2分),应用单因素与多因素logistic回归分析法分析全静脉麻醉PONV的影响因素。结果:3532例全静脉麻醉手术患者中发生PONV 1055例,占比29.87%。PONV组年龄<50岁、有既往PONV史及高血压病史患者占比高于对照组,术后复苏期间预防性处理患者占比低于对照组,差异有统计学意义(P<0.05)。多因素logistic回归分析结果显示年龄<50岁、有既往PONV史及高血压病史是PONV发生的危险因素(P<0.05),术后复苏期间预防性处理是PONV发生的保护因素(P<0.05)。结论:年龄<50岁、有既往PONV史及高血压病史是女性手术患者发生PONV的危险因素,术后复苏期间预防性处理是其保护因素,临床可对以上高危因素人群术后给予更多关注,适当中医方法进行干预,以降低PONV发生风险。

Objective:To analyze the influencing factors of postoperative nausea and vomiting(PONV)in female surgical patients under total intravenous anesthesia.Method:The clinical data of 3532 female patients underwent total intravenous anesthesia in the Anesthesiology Department of Shenzhen Hospital of Guangzhou University of Chinese Medicine from January 2021 to April 2022 were analyzed retrospectively.Among 3532 patients were divided into PONV group(n=1055,PONV>2 points)and control group(n=2477,PONV≤2 points)using the PONV score.The influencing factors of total intravenous anesthesia PONV were analyzed using univariate and multivariate logistic regression analysis.Result:Among 1055 out of 3532 patients underwent total intravenous anesthesia surgery developed PONV,accounting for 29.87%.In PONV group,the proportion of patients<50 years old,a history of previous PONV,and a history of hypertension were higher than those of the control group,and the proportion of patients with preventive treatment during postoperation resuscitation was lower than that of the control group,the differences were statistically significant(P<0.05).The results of multivariate logistic regression analysis showed that age<50 years,a history of previous PONV,and a history of hypertension were risk factors for the occurrence of PONV(P<0.05),and preventive treatment during postoperation resuscitation was a protective factor for the occurrence of PONV(P<0.05).Conclusion:Age<50 years,previous history of PONV,and history of hypertension are risk factors for the occurrence of PONV in female surgical patients.Preventive treatment during postoperation resuscitation is a protective factor.Clinical attention can be paid to the high-risk factors mentioned above after surgery,and appropriate traditional Chinese medicine methods can be used to intervene to reduce the risk of PONV occurrence.