经蝶垂体瘤手术后恶心呕吐的发生率及其危险因素分析  

Incidence and risk factors of postoperative nausea and vomiting after transsphenoidal surgery for pituitary adenoma

作　　者：徐振东[1] 车薛华[2] 党丹丹[2] 焦微[2] 徐江慧[2] 

机构地区：[1]同济大学附属第一妇婴保健院麻醉科,上海200040 [2]复旦大学附属华山医院麻醉科

出　　处：《国际麻醉学与复苏杂志》2014年第1期12-15,共4页International Journal of Anesthesiology and Resuscitation

摘　　要：目的调查经蝶垂体瘤手术后恶心呕吐（postoperative nausea and vomiting，PONV）的发生睛况，研究影响其发生率的危险因素。方法通过前瞻性观察研究的方法，对2012年5月-10月期间在复旦大学附属华山医院行择期经蝶垂体瘤手术的120例患者进行观察，记录患者在麻醉后恢复室（postanesthesia care unit，PACU）、术后6h内和6h-24h内PONV的发生率，并分析影响PONV发生率的因素。结果经蝶垂体瘤手术PONV总的发生率为22．5％（27／120），其中在PACU的发生率为1．7％（2／120），手术后6h内为11．7％（14／120），术后6h～24h为15％（18／120）。单因素分析显示，PONV组女性的比例和术后6h疼痛评分均明显高于非PONV组（P〈0．01）。PONV多因素分析结果提示女性（OR4．69，95％CI1．4—15．5）和术后6h较高的疼痛评分（OR3．54，95％CI2．1～6．0）是发生PONV的独立危险因素。结论女性和疼痛是经蝶垂体瘤PONV的危险因素。Objective To assess the incidence and risk factors of postoperative nausea and vomiting （PONV） after transsphenoidal surgery for pituitary adenoma. Methods PONV was prospectively assessed within 24 h after surgery in 120 patients, who underwent transsphenoidal surgery for pituitary adenoma in Huashan Hospital from May to October 2012. Results The overall incidence of PONV was 22.5% during the first 24 h postoperatively. Two patients developed PONV in the postanesthesia care unit （PACU）, 14 patients within 6 h following surgery while 18 patients within 6 h-24 h following surgery. The proportion of female and pain scores were higher in patients with PONV than in patients without PONV （P〈0.01）. Logistic regression identified female sex （OR 4.69, 95%CI 1.4-15.5） and high pain scores （OR 3.54, 95%CI 2.1-6.0） at 6 h after surgery as risk factors for PONV. Conclusions Transsphenoidal surgery has a moderate incidence of PONV. Both female and postoperative pain increase the risk of PONV.

关 键 词：手术后恶心呕吐 全身麻醉 神经外科 

分 类 号：R739.4[医药卫生—肿瘤]