胸腔镜肺部手术后恶心呕吐严重程度与术后恢复质量及活动能力的相关性  

Correlation between severity of nausea and vomiting after thoracoscopic pulmonary surgery and quality of postoperative recovery and capacity of mobility

作　　者：闫翔 蒋嘉[1] 傅毅立[2] 魏昌伟 YAN Xiang;JIANG Jia;FU Yili;WEI Changwei(Department of Anesthesiology,Beijing Chao-Yang Hospital,Capital Medical University,Beijing 100020,China)

机构地区：[1]首都医科大学附属北京朝阳医院麻醉科,100020 [2]首都医科大学附属北京朝阳医院胸外科,100020

出　　处：《临床麻醉学杂志》2024年第2期139-143,共5页Journal of Clinical Anesthesiology

摘　　要：目的评估胸腔镜肺部手术患者术后恶心呕吐(PONV)严重程度与术后恢复质量及早期活动能力的相关性。方法选择择期胸腔镜肺部手术患者125例,男80例,女45例,年龄18~64岁,BMI 18~35 kg/m^(2),ASAⅠ—Ⅲ级。采用PONV影响量表评估术后第1天PONV的严重程度,根据严重程度将患者分为三组:无PONV组(n=87)、轻度PONV组(n=38)和中重度PONV组(n=7)。采用15项恢复质量(QoR-15)量表评估术后第1天的恢复质量,6分钟步行试验(6-MWT)评估术后第2天的活动能力。采用多重线性回归模型分析PONV严重程度与术后恢复质量及活动能力的相关性。结果校正后的多重线性回归模型结果显示,与无PONV患者比较,轻度和中重度PONV患者术后第1天QoR-15量表评分分别降低4.5分(95%CI-8.9~-0.04分,P=0.048)和15.8分(95%CI-24.8~-6.8分,P=0.001);轻度(MD=-27.4 m,95%CI-70.1~15.4 m,P=0.207)和中重度PONV(MD=-57.0 m,95%CI-145.7~31.6 m,P=0.204)与术后第2天6-MWT距离缩短无明显相关性。结论在肺部手术患者中,PONV严重程度的增加与更差的恢复质量存在相关性。积极地预防和治疗PONV可能有助于患者的早期康复。Objective To assess the correlation between the severity of postoperative nausea and vomiting(PONV)with the quality of postoperative recovery and capacity of mobility in patients after video-assisted thoracoscopic surgery.Methods A total of 125 patients,80 males and 45 females,aged 18-64 years,BMI 18-35 kg/m^(2),ASA physical statusⅠ-Ⅲ,undergoing video-assisted thoracoscopic surgery were observed.The severity of PONV was assessed using the simplified PONV impact scale day 1 after surgery.The patients were divided into three groups according to the severity of PONV:non-PONV group(n=87),mild PONV group(n=31),and moderate to severe PONV group(n=7).The quality of recovery was assessed using the quality of recovery-15(QoR-15)on the first day after surgery,and the capacity of mobility was assessed using the 6-minute walk test(6-MWT)on the second day after surgery.The multiple linear regression model was used to analyze the correlation between the severity of PONV and quality of postoperative recovery and capacity of mobility.Results The results of the corrected multiple linear regression model showed that,compared with the patients without PONV,the QoR-15 scores of the patients with mild and moderate-severe PONV on the first day after surgery were reduced by 4.5 scores(95%CI-8.9 to-0.04 scores,P=0.048)and 15.8 scores(95%CI-24.8 to-6.8 scores,P=0.001),respectively.Mild(MD=-27.4 m,95%CI-70.1 to 15.4 m,P=0.207)and moderate-severe PONV(MD=-57.0 m,95%CI-145.7 to 31.6 m,P=0.204)were not significantly associated with 6-MWT distance shortening on the second day after surgery.Conclusion Increased PONV severity is associated with poorer recovery quality in patients undergoing pulmonary surgery.Active prevention and treatment of PONV may contribute to early recovery of patients.

关 键 词：肺部手术 术后恶心呕吐 恢复质量 6分钟步行实验 胸腔镜 

分 类 号：R614[医药卫生—麻醉学]