急性脑梗死取栓术后恶心呕吐发生现状及影响因素分析

Analysis of the Occurrence and Influencing Factors of Nausea and Vomiting after Thrombectomy in Acute Cerebral Infarction

目的探讨急性脑梗死取栓术后恶心呕吐(Postoperative Nausea and Vomiting,PONV)发生现状及影响因素。方法回顾性分析2020年3月—2022年6月在福建医科大学附属协和医院急诊行动脉取栓术的103例急性脑梗死患者的临床资料,根据术后发生PONV情况分为PONV组(n=34)、非PONV组(n=69)。对比两组患者的性别、年龄、生活习惯(吸烟、饮酒)、晕动史、偏头痛史、预防性使用止吐药、使用镇痛泵、手术时长等基础资料,分析急性脑梗死取栓术后发生恶心呕吐的影响因素。结果103例脑梗死取栓术患者,发生PONV34例。PONV组、非PONV组患者的年龄、吸烟、饮酒、偏头痛史、手术时长比较,差异无统计学意义(P均>0.05)。两组性别、晕动史、预防性使用止吐药、使用镇痛泵的分布比较,差异有统计学意义(P均<0.05)。单因素、多因素Logistics回归分析发现,女性、晕动史、使用镇痛泵是急性脑梗死取栓术患者PONV发生的独立危险因素,预防性使用止吐药是急性脑梗死取栓术患者PONV发生的保护性因素(OR=1.732、1.653、1.498、0.565,P均<0.05)。结论女性、晕动史、使用镇痛泵是急性脑梗死取栓术患者PONV发生的独立危险因素,预防性使用止吐药是急性脑梗死取栓术患者PONV发生的保护性因素。

Objective To investigate the occurrence and influencing factors of postoperative nausea and vomiting(PONV)in acute cerebral infarction.Methods The clinical data of 103 patients with acute cerebral infarction who underwent emergency operation of vein thrombectomy in Union Hospital of Fujian Medical University from March 2020 to June 2022 were retrospectively analyzed,and they were classified into the PONV group(n=34)and the non-PONV group(n=69)according to the occurrence of PONV after surgery.Basic data such as gender,age,life habits(smoking,drinking),history of motion sickness,history of migraine,prophylactic use of antiemetic drugs,use of analgesic pumps,and length of surgery were compared between the two groups to analyze the factors influencing the occurrence of nausea and vomiting after surgery for thrombolysis in acute cerebral infarction.Results In 103 patients with cerebral infarction thrombectomy,PONV occurred in 34 cases.There was no statistically significant difference in the comparison of age,smoking,alcohol consumption,history of migraine,and length of surgery between patients in the PONV group and the non-PONV group(all P>0.05).Compared the distribution of gender,history of motion sickness,prophylactic use of antiemetics,and use of analgesic pumps between the two groups,the difference was statistically significant(all P<0.05).Univariate and multifactorial logistic regression analyses revealed that female,history of motion sickness,and use of analgesic pumps were independent risk factors for the occurrence of PONV in patients undergoing embolization for acute cerebral infarction,and prophylactic use of antiemetic medication was a protective factor for the occurrence of PONV in patients undergoing embolization for acute cerebral infarction(OR=1.732,1.653,1.498,0.565,all P<0.05).Conclusion Female,motion sickness history and use of analgesic pump are independent risk factors for PONV in patients undergoing thrombectomy for acute cerebral infarction.Preventive use of antiemetics is protective factor for PONV in patients undergoing thrombectomy for acute cerebral infarction.