减重手术胃肠道血流量下降的原因及干预措施

Influencing factors and interventions of decreased gastrointestinal blood flow during bariatric surgery

术后恶心呕吐(PONV)是减重手术最常见的术后不良反应之一,降低患者舒适度和满意度,也会减慢术后康复进程。PONV的诱发因素有很多,其中减重手术围术期胃肠道血流量的下降,导致胃肠粘膜缺血缺氧及术后胃肠功能紊乱,是引起PONV发生的危险因素之一。对此,本文围绕减重手术的麻醉药物、手术因素以及术前禁食等方面进行分析,探讨了围术期引起胃肠道血流量下降的原因,并对改善胃肠道组织缺血缺氧的干预措施进行了总结和概述,期望能够通过改善胃肠道血流量从而缓解减重手术PONV的发生。

Post operative nausea and vomiting(PONV)is one of the most common postoperative adverse effects of bariatric surgery,reducing patient comfort and satisfaction and slowing down the recovery process.There are many predisposing factors of PONV,among which the decrease in gastrointestinal blood flow during the perioperative period of bariatric surgery,resulting in gastrointestinal mucosal ischemia and hypoxia and postoperative gastrointestinal dysfunction,are one of the risk factors for the occurrence of PONV.In this regard,this article analyzes anesthetic drugs,surgical factors and preoperative fasting of bariatric surgery,discusses the reasons for the decline of gastrointestinal blood flow in the perioperative period,and summarizes the interventions to improve gastrointestinal tissue ischemia and hypoxia,hoping to alleviate the occurrence of PONV in bariatric surgery by improving gastrointestinal blood flow.