帕金森患者行脑深部电刺激发生术后恶心呕吐的危险因素分析  

Risk factors of postoperative nausea and vomiting in Parkinson's disease patients after deep brain stimulation surgery

作　　者：陈玮 蒋慧慧 郑初蕾 阮义峰[2] 章文斌[3] 邱畅 李冰冰[4] CHEN Wei;JIANG Huihui;ZHENG Chulei;RUAN Yifeng;ZHANG Wenbin;QIU Chang;LI Bingbing(Medical School of Nanjing University,Nanjing 210029,China)

机构地区：[1]南京大学医学院,南京2100029 [2]南京医科大学附属脑科医院麻醉科 [3]南京医科大学附属脑科医院功能神经外科 [4]南京大学医学院附属鼓楼医院麻醉科

出　　处：《临床神经外科杂志》2024年第6期636-640,647,共6页Journal of Clinical Neurosurgery

基　　金：江苏省重点研发计划,产业前瞻与关键技术研究项目(BE2022049);江苏省重点研发计划,产业前瞻与关键技术研究项目(BE2022049-1);南京市卫生科技发展专项资金重点项目(ZKX20031)。

摘　　要：目的 分析原发性帕金森(PD)患者行脑深部电刺激后发生术后恶心呕吐(PONV)的危险因素。方法 回顾性分析2016年1月-2023年6月在南京脑科医院行脑深部电刺激的431例患者的临床资料,包括患者性别、年龄、体质量指数、既往病史、术中用药、术中血压、术中体温、麻醉深度、术后转归等指标,根据术后24 h内是否发生恶心呕吐分为PONV组和非PONV组。进行单因素分析后,采用多因素Logistic回归分析确定脑深部电刺激PONV的危险因素。结果 PD患者行DBS后的PONV发生率为9.3%。女性(P=0.027)、上消化道手术史(P=0.022)、术中发生低体温(P=0.003)、术中使用地佐辛(P=0.027)是PONV的独立危险因素;局麻+全麻的麻醉方式(P=0.027)是其保护性因素。结论 女性、上消化道手术史、术中发生低体温、术中使用地佐辛是PONV的独立危险因素;局麻+全麻的麻醉方式是其保护性因素。Objective To analyze the risk factors of postoperative nausea and vomiting(PONV)in patients with primary Parkinson s disease(PD)after deep brain stimulation(DBS).Methods The clinical data of 431 patients who underwent DBS in Nanjing Brain Hospital from January 2016 to June 2023 were analyzed retrospectively,including gender,age,body mass index,past medical history,intraoperative medication,intraoperative blood pressure,intraoperative temperature,depth of anesthesia,postoperative outcome and other indexes.The patients were divided into PONV group and non-PONV group according to whether nausea and vomiting occurred within 24 hours after operation.After univariate analysis,multivariate logistic regression analysis was used to determine the risk factors for PONV after DBS.Results The incidence of PONV in patients with PD was 9.3%.Female(P=0.027),history of upper gastrointestinal surgery(P=0.022),intraoperative hypothermia(P=0.003)and intraoperative dezocine(P=0.027)were independent risk factors for PONV.Local anesthesia+general anesthesia(P=0.027)were protective factors.Conclusions Female,history of upper gastrointestinal surgery,hypothermia during surgery and intraoperative use of dezocine are independent risk factors for PONV.Local and general anesthesia were protective factors.

关 键 词：术后恶心呕吐 术后并发症 帕金森病 脑深部电刺激 危险因素 

分 类 号：R651[医药卫生—外科学]