术中呼气末二氧化碳水平对妇科腹腔镜手术老年患者发生术后恶心呕吐的影响  

The impact of end-tidal carbon dioxide levels during the operation on postoperative nausea and vomit⁃ing in elderly patients undergoing gynecological laparoscopic surgery

作　　者：王明玉[1] 衡垒 WANG Mingyu;HENG Lei(Department of Anesthesiology,Xuzhou Maternal and Child Health Hospital,Xuzhou 221000,China;Department of Anesthesiology,Xuzhou New Health Geriatric Hospital,Xuzhou 221000,China)

机构地区：[1]徐州市妇幼保健院麻醉科,江苏徐州221000 [2]徐州新健康老年病医院麻醉科,江苏徐州221000

出　　处：《老年医学研究》2025年第1期20-23,共4页Geriatrics Research

摘　　要：目的 探讨术中呼气末二氧化碳(EtCO_(2))水平对妇科腹腔镜手术老年患者发生术后恶心呕吐(PONV)的影响。方法 选择2023年1月—2024年10月就诊于徐州妇幼保健院医院并接受择期妇科腹腔镜手术的老年患者197例。通过病房医生系统收集资料,术中使用旁流气体分析仪连续监测EtCO_(2),通过麻醉信息管理系统采集EtCO_(2),并将病例分为EtCO_(2)≤45 mmHg与EtCO_(2)>45 mmHg者。术后2天观察主要结局指标(PONV)、次要结局指标(恶心、呕吐、术后输血、术后住院天数、住院费用、手术部位感染、再手术和伤口出血、渗血、血肿)。采用多因素logistic回归分析筛选出妇科腹腔镜手术老年患者发生PONV的影响因素,探讨术中EtCO_(2)水平与妇科腹腔镜手术老年患者发生PONV的关系。结果 多因素logistic回归分析表明,术中EtCO_(2)>45 mmHg(OR=4.637,95%CI:2.414~8.906,P<0.001)是妇科腹腔镜手术老年患者术后2天内出现PONV的危险因素。122例术中EtCO_(2)>45 mmHg的患者中有83例术后2天内发生PONV,高于术中EtCO_(2)≤45 mmHg的患者(23例),两者比较P<0.05。结论 术中EtCO_(2)>45 mmHg为妇科腹腔镜手术老年患者术后2天内发生PONV的危险因素。Objective To investigate the impact of intraoperative end-tidal carbon dioxide(EtCO_(2))levels on postop-erative nausea and vomiting(PONV)in elderly patients undergoing gynecological laparoscopic surgery.Methods A to-tal of 197 elderly patients who were treated at Xuzhou Maternity and Child Health Hospital and underwent gynecological laparoscopic surgery from January 2023 to October 2024 were included.Data were collected through the ward doctor sys-tem,and intraoperative EtCO_(2) was continuously monitored using a sidestream gas analyzer,and recorded through the anes-thesia information management system.The cases were divided into EtCO_(2)≤45 mmHg and EtCO_(2)>45 mmHg.Primary out-come indicator(PONV)and secondary outcome indicators(nausea,vomiting,postoperative blood transfusion,postopera-tive hospitalization days,hospitalization costs,surgical site infection,reoperation,wound bleeding,bleeding,hemato-ma)were observed 2 days after surgery.Multivariate logistic regression analysis was used to identify independent risk fac-tors of PONV in elderly patients undergoing gynecological laparoscopic surgery and investigate the relationship between EtCO_(2) level and PONV in elderly patients undergoing gynecological laparoscopic surgery.Results Multivariate logistic regression analysis revealed that average intraoperative EtCO_(2)>45 mmHg(OR=4.637,95%CI:2.414-8.906,P<0.001)was an independent risk factor for PONV in elderly patients undergoing gynecological laparoscopic surgery within two days post-surgery.Among the 122 patients with an average intraoperative EtCO_(2)>45 mmHg,83 experienced PONV within two postoperative days,significantly higher than the 23 patients with average EtCO_(2)≤45 mmHg(P<0.05).Conclusion Av-erage intraoperative EtCO_(2)>45 mmHg is an independent risk factor for PONV within two days post-surgery in elderly pa-tients undergoing gynecological laparoscopic surgery.

关 键 词：呼气末二氧化碳 术后恶心呕吐 腹腔镜手术 老年人 

分 类 号：R713[医药卫生—妇产科学]