卵巢切除对妇科患者全身麻醉术后恶心呕吐的影响:一项基于倾向性评分匹配的回顾性队列研究  

Effect of Ovariectomy on Postoperative Nausea and Vomiting in Gynecological Patients under General Anesthesia:A Retrospective Cohort Study Based on the Propensity Score Matching

作　　者：龚灿生[1] 许文言 廖燕凌[1] 郑艇[1] 蒋俊丹[1] 郑晓春[1] GONG Cansheng;XU Wenyan;LIAO Yanling;ZHENG Ting;JIANG Jundan;ZHENG Xiaochun(Shengli Clinical Collage of Fujian Medical University, Department of Anesthesiology of Fujian Provincial Hospital, Fuzhou 350001, China)

机构地区：[1]福建医科大学省立临床医学院,福建省立医院麻醉科,福州350001

出　　处：《福建医科大学学报》2020年第6期436-440,共5页Journal of Fujian Medical University

摘　　要：目的应用倾向性评分匹配方法,探讨卵巢切除对妇科患者全麻术后恶心呕吐(PONV)的影响。方法回顾性分析2018年1月1日-12月31日接受妇科手术的1400例患者的资料,收集患者的基本特征、手术因素、麻醉因素及PONV发生情况。根据术中是否进行卵巢切除,将患者分为卵巢切除组和非卵巢切除组,应用倾向性评分匹配控制两组间混杂因素,分析两组间PONV发生率的差异。结果1400例中,卵巢切除组407例,非卵巢切除组993例。两组患者的年龄、体质量、吸烟史、病理性质、手术类型、手术方式、手术时间、麻醉方法、术中舒芬太尼用量差别均有统计学意义(P<0.05)。通过倾向性评分匹配,共有271对患者匹配成功。倾向评分匹配后,以上因素组间差别无统计学意义,均衡性良好。匹配后卵巢切除组PONV发生率为33.21%,高于非卵巢切除患者的24.35%(P=0.023)。与非卵巢切除患者比较,卵巢切除患者发生PONV的相对危险度为1.51(95%CI为1.04~2.20)。结论卵巢切除可增加妇科全麻手术患者PONV风险。Objective To evaluate the effect of ovariectomy on postoperative nausea and vomiting(PONV)in gynecological patients under general anesthesia using the propensity score matching(PSM).Methods Perioperative data from patients who underwent gynecological surgery in Fujian Provincial Hospital were retrospectively analyzed.General characteristics,operative factors,anesthetic factors and occurrence of PONV were collected.Patients were divided into ovariectomized group and non-ovariectomized group according to fact that the ovary was dissected or not.The incidence of PONV were compared between the two groups after confounder controlling by using PSM.Results A total of 1400 patients were finally included in the analyses,407 cases in the ovariectomized group and 993 in the non-ovariectomized group.Before matching,there were significant difference in age,body weight,smoking,pathology,surgery duration,surgical type,surgical procedure,anesthesia type,intraoperative sufentanil consumption between groups(P<0.05).After propensity score matching,271 cases remained in each group,with a good matching balance.The incidence of PONV in ovariectomized group was significantly higher than that of non-ovariectomized group(33.21%vs 24.35%,P=0.023;RR=1.51,95%CI=1.04-2.20).Conclusion Ovary dissection can increased the risk of PONV in gynecological patients under general anesthesia.

关 键 词：卵巢切除术 手术后恶心呕吐 流行病学方法 

分 类 号：R322.65[医药卫生—人体解剖和组织胚胎学] R442.1[医药卫生—基础医学]