椎管内麻醉术后恶心呕吐的危险因素分析  

Analysis of risk factors for postoperative nausea and vomiting in spinal anesthesia patients

作　　者：陈昊[1] 方刚[1] 李曼[1] 梅伟[1] 田玉科[1] 

机构地区：[1]华中科技大学同济医学院附属同济医院麻醉科,武汉430030

出　　处：《中国医师进修杂志》2013年第15期1-3,共3页Chinese Journal of Postgraduates of Medicine

基　　金：卫生部国家临床重点专科建设经费资助

摘　　要：目的探讨椎管内麻醉术后恶心呕吐（PONV）发生的相关危险因素。方法对841例接受椎管内麻醉患者术后进行随访。采用单因素分析和多元Logistic回归分析，筛选发生PONV的相关危险因素。结果94例发生了PONV，占11．2％（94／841）。单因素分析结果显示，PONV与性别、年龄、ASA分级及麻醉方式无关（P〉0．05），与手术科室（P=0．026）、体质指数（P=0．020）、教育程度（P：0．000）、既往手术麻醉史（P=0．005）、PONV病史（P=0．000）、晕动病史（P=0．002）、吸烟（P=0．019）、术中应用曲马多（P=0．018）有相关性。在多因素分析中，手术科室（OR=4．039，95％CI1．331-12．259，P=0．048）、教育程度（OR=3．504，95％CI1．486-8．260，P=0．015）、PONV病史（OR=5．113，95％CI1．790-14．606，JP=0．002）、术中应用曲马多（OR=5．316，95％CI1．091-25．908，P=0．039）是PONV发生的独立危险因素。结论椎管内麻醉PONV显著的相关危险因素包括手术科室、教育程度、PONV病史和术中应用曲马多。识别有PONV高风险的患者将有助于提供更及时的处理方案。Objective To investigate the risk factors for postoperative nausea and vomiting （PONV） in spinal anesthesia patients. Methods A total of 841 patients received spinal anesthesia were visited after operation. Data were analyzed using univariate analysis and multivariate Logistic regression to identify risk factors related to PONV. Results PONV occurred in 94 patients （ 11.2%, 94/841 ）. Univariate analysis showed that PONV was unrelated with gender, age, ASA classification, anesthesia mode （P 〉 0.05 ）, related with operation department （P = 0.026） ,body mass index （P = 0.020） ,education level （P = 0.000）, history of previous surgery anesthesia （P = 0.005 ）, history of PONV （P = 0.000）, history of kinesia （P = 0.002） ,smoke （P = 0.019）,intraoperative using of tramadol （P = 0.018）. Multivariate analysis showed that operation department（OR = 4.039,95% CI 1.331-12.259,P=-0.048）,education level （OR = 3.504,95% CI 1.486 - 8.260,P= 0.015）,history of PONV （OR = 5.113,95% CI 1.790 - 14.606,P= 0.002）,intraoperative using of tramadol （OR = 5.316,95% CI 1.091 -25.908,P = 0.039） were identified as independent risk factors for PONV. Conclusions The independent factors associated with PONV following spinal anesthesia include operation department, education level, history of PONV,intraoperative using of tramadol. Identifying patients who are at high risk for PONV will enable the formation of more timely management proiect.

关 键 词：椎管 麻醉 手术后恶心呕吐 危险因素 

分 类 号：R614[医药卫生—麻醉学]