非胃肠道日间手术患儿术后早期经口进食恶心呕吐的危险因素  

Risk factors for early oral intake nausea and vomiting after pediatric non-gastrointestinal day-case surgery

作　　者：金雨葶 刘丹晴 周盈丰 章钰 白玥 励建琳 袁开明[1] 李军[1] JIN Yuting;LIU Danqing;ZHOU Yingfeng;ZHANG Yu;BAI Yue;LI Jianlin;YUAN Kaiming;LI Jun(Department of Anesthesiology and Perioperative Medicine,the Second Affiliated Hospital&Yuying Children′s Hospital,Wenzhou Medical University,Wenzhou 325027,China)

机构地区：[1]温州医科大学附属第二医院育英儿童医院麻醉与围术期医学科,325027

出　　处：《临床麻醉学杂志》2023年第3期246-249,共4页Journal of Clinical Anesthesiology

基　　金：重大新药创制国家科技重大专项(2020ZX09201002)。

摘　　要：目的分析影响患儿非胃肠道日间手术后早期经口进食恶心呕吐(EOINV)的危险因素。方法选择2020年6月至2022年3月全麻下行非胃肠道日间手术、麻醉后进食前未发生恶心呕吐的患儿306例,男206例,女100例,年龄1~12岁,体重5~60 kg,ASAⅠ或Ⅱ级。收集患儿性别、年龄、体重、术前禁食禁饮时间、麻醉方式、术中阿片类药、肌松药和肌松拮抗药使用情况、手术类型、手术时间、麻醉时间和术后24 h内EOINV的发生情况。根据EOINV的发生情况将患儿分为两组:EOINV组和无EOINV组,通过单因素与多因素Logistic回归分析患儿EOINV的独立危险因素。结果有46例(15.0%)患儿发生EOINV。两组患儿性别、年龄、体重、术前禁食禁饮时间、麻醉方式、肌松药和拮抗药使用情况、手术时间、麻醉时间差异无统计学意义。与无EOINV组比较,EOINV组阿片类药使用率和口内手术比例明显升高(P<0.05)。二元Logistic回归分析结果显示,术中阿片类药使用(OR=3.7,95%CI 1.0~12.5,P=0.048)、口内手术(OR=4.8,95%CI 1.3~16.7,P=0.017)是患儿非胃肠道手术后EOINV的独立危险因素。结论术中阿片类药使用、口内手术是患儿非胃肠道日间手术后早期经口进食恶心呕吐的独立危险因素。Objective To analyze the risk factors for early oral intake nausea and vomiting(EOINV)after pediatric non-gastrointestinal day-case surgery.Methods A total of 306 children,206 males and 100 females,aged 1-12 years,weighting 5-60 kg,ASA physical statusⅠorⅡ,who underwent non-gastrointestinal day-case surgery under general anesthesia without postoperative nausea and vomiting before eating from June 2020 to March 2022 were included.Children's gender,age,weight,preoperative fasting and drinking time,anesthesia methods,intraoperative opioids use,muscle relaxant and muscle relaxant antagonistuse,the type of surgery,the operative time and the anesthesia time were collected.The incidence of EOINV within 24 hours after surgery was followed up,and the children were divided into two groups:EOINV group and non-EOINV group.Univariate and multivariate Logistic regression model was performed to analyze the independent risk factors of EOINV.Results EOINV occurred in 46 children(15.0%).There were no significant differences in the gender,age,weight,preoperative fasting and drinking time,anesthesia methods,intraoperative muscle relaxant and its antagonist use,the operative time and the anesthesia time between the two groups.Compared with non-EOINV group,the use rate of intraoperative opioids and the proportion of intraoral surgery in EOINV group were significantly higher(P<0.05).Binary logistic regression analyses showed that intraoperative opioids use(OR=3.7,95%CI 1.0-12.5,P=0.048)and intraoral surgery(OR=4.8,95%CI 1.3-16.7,P=0.017)were the independent risk factors for EOINV.Conclusion Intraoperative opioids use and intraoral surgery were the independent risk factors for EOINV after pediatric non-gastrointestinal day-case surgery.

关 键 词：儿童 非胃肠道日间手术 早期经口进食 恶心呕吐 危险因素 

分 类 号：R726.1[医药卫生—儿科]