儿童日间手术发生POV的危险因素分析  

Analysis of risk factors for the occurrence of POV in children following day surgery

作　　者：张勇 ZHANG Yong(Guangzhou Women and Children's Medical Center,Guangzhou 510623,China)

机构地区：[1]广州市妇女儿童医疗中心,510623

出　　处：《中国实用医药》2024年第5期65-67,共3页China Practical Medicine

摘　　要：目的 分析儿童日间手术发生术后呕吐(POV)的危险因素。方法 回顾性分析8974例儿童日间手术患儿的临床资料,采用单因素检验分析POV患儿的临床特征,多因素Logistic回归分析POV的危险因素。结果 8974患儿中男6736例,女2238例;平均年龄(5.43±2.82)岁。手术类型包括耳鼻喉科、普外科、泌尿外科、骨科、眼科和口腔科手术;平均麻醉时间(37.65±31.94)min;平均手术时间(26.60±30.08)min。发生POV的患儿共468例(5.2%),可作为呕吐组,其余8506例患儿作为无呕吐组。呕吐组与未呕吐组患儿年龄、年龄段、性别、手术时间、麻醉时间、麻醉方式(气管插管/喉罩)、手术类型(耳鼻喉科、普外科、泌尿外科、骨科、口腔科手术)比较均无明显差异(P>0.05);呕吐组患儿眼科手术占比2.6%低于无呕吐组的5.9%,腹腔镜手术占比29.5%、13点后开始手术占比53.6%高于无呕吐组的23.8%、48.2%,差异具有统计学意义(P<0.05)。将单因素检验中P<0.05的变量腹腔镜手术、13点后开始手术、眼科手术纳入多因素Logistic回归分析,结果显示:腹腔镜手术是POV的独立危险因素(OR=1.29, P=0.017<0.05),眼科手术是POV的保护因素(OR=0.46, P=0.011<0.05)。结论 腹腔镜是儿童日间手术患儿POV发生的独立危险因素。评估儿童日间手术患儿POV风险时,需将手术方式纳入考虑。Objective To analyze the risk factors for the occurrence of postoperative vomiting(POV)in children following day surgery.Methods The clinical data of 8974 pediatric patients with day surgery was retrospectively analyzed.Results Among the 8974 children,6736 were male and 2238 were female.The mean age was(5.43±2.82)years.Types of surgery include otolaryngology,general surgery,urology,orthopedics,ophthalmology and stomatology.The average duration of anesthesia was(37.65±31.94)min,and the average operation time was(26.60±30.08)min.468 children(5.2%)with POV were included in the vomiting group,and the remaining 8506 patients were included in the non-vomiting group.There were no significant differences in age,age group,gender,operation time,anesthesia time,anesthesia mode(tracheal intubation/laryngeal mask airway insertion),and surgical type(otolaryngology,general surgery,urology,orthopedics,stomatology surgery)between vomiting group and non-vomiting group(P>0.05).The proportion of eye surgery in vomiting group was 2.6%,which was lower than 5.9%in non-vomiting group;the proportion of laparoscopic surgery was 29.5%,and the proportion of surgery after 13 o'clock was 53.6%,which was higher than 23.8%and 48.2%in non-vomiting group.The difference was statistically significant(P<0.05).Variables with P<0.05 in the univariate test,including laparoscopic surgery,surgery after 13 o'clock,and eye surgery,were included in the multivariate Logistic regression analysis.The results showed that laparoscopic surgery was an independent risk factor for POV(OR=1.29,P=0.017<0.05),and eye surgery was a protective factor for POV(OR=0.46,P=0.011<0.05).Conclusion Laparoscopey is an independent risk factor for the occurrence of POV in pediatric patients following day surgery.When assessing the risk of POV in pediatric patients,surgical modalities need to be taken into account.

关 键 词：儿童 日间手术 危险因素 术后呕吐 

分 类 号：R726.5[医药卫生—儿科]