影响腹腔镜胆囊切除术后恶心呕吐相关因素的Logistic回归分析  

Logistic regression analysis of factors correlated to postoperative nausea and vomiting of laparoscopic cholecystectomy

作　　者：彭钊[1] 邝学军[1] 何松[1] 王建钧[1] 刘力[1] 

机构地区：[1]湘南学院附属医院肝胆外科,湖南郴州423000

出　　处：《湘南学院学报（医学版）》2014年第4期19-22,共4页Journal of Xiangnan University（Medical Sciences）

摘　　要：目的探讨腹腔镜胆囊切除术后发生恶心呕吐的危险因素,为改善患者术后生活质量提供指导。方法回顾性分析因胆囊良性疾病实施腹腔镜胆囊切除术的194例患者的临床病理资料,以术后发生恶心呕吐中度和重度者划分为恶心呕吐组,以未发生和发生恶心呕吐轻度者划分为对照组。通过单因素和多因素分析对10项潜在的可能影响腹腔镜胆囊切除术后恶心呕吐的临床病理因素进行统计学分析。结果 194例患者中有87例发生术后恶心呕吐,发生率为44.8%。单因素分析结果示:两组之间性别、体质量指数、晕车晕船病史、术中留置胃管、术中气腹压力和麻醉苏醒时间的差异有统计学意义(P<0.05)。多因素分析结果示:性别、体质量指数、晕船晕车病史、术中留置胃管和术中气腹压力是影响腹腔镜胆囊切除术后恶心呕吐的有统计学意义的因素(P<0.05)。结论腹腔镜胆囊切除术后恶心呕吐取决于多种因素的共同作用,女性、体质量指数≥25%kg/m^2、有晕车晕船病史和术中气腹压力≥14mmHg是影响LC术后恶心呕吐的独立危险因素,术中留置胃管是保护性因素。Objective To explore the correlation factors of postoperative nausea and vomiting after laparo_scopic cholecystectomy （ LC） for providing guidance of improving the quality of life. Methods The clinical and pathologic data of 194 patients who underwent LC due to benign gallbladder disease from June 2011 to June 2013 were retrospectively analyzed. The patients who suffer from postoperative nausea and vomiting （ PONV） after LC moderately and severely were divided into PONV groups, the patients who have no PONV or mild after LC were divided into control groups. Ten potential pathological factors for PONV after LC were statistically analyzed by univariate analysis and multivariate analysis. Results 87 cases of patients （44. 8%） occurred PONV. Univariate analysis showed that the differences of gender, body mass index, rider vertigo history, intraoperative indwelling nasogastric decompression tube, intraoperative pneumoperitoneum pressure and Anesthesia waking time between two groups had statistical difference（ P〈0. 05）. Multivariate analysis indicated that gender, body mass index, rider vertigo history, intraoperative indwelling nasogastric decom_pression tube and intraoperative pneumoperitoneum pressure were statistically significant factors for PONV af_ter LC（ P〈0. 05）. Conclusions The PONV after LC depends on various kinds of factors together. The in_dependent risk factors influencing PONV after LC include female sex, body mass index≥25% kg/m2 , rider vertigo history and intraoperative pneumoperitoneum pressure≥14 mmHg. Intraoperative indwelling nasogas_tric decompression tube is a protective factor.

关 键 词：腹腔镜胆囊切除术 术后恶心呕吐 危险因素 多因素分析 

分 类 号：R657.4[医药卫生—外科学]