月经周期不同阶段对妇科腹腔镜手术后恶心呕吐的影响被引量：7

Effects of the menstrual cycle on the incidence of nausea and vomiting after laparoscopic gynecological surgery

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摘要目的观察月经周期不同阶段对妇科腹腔镜手术后恶心呕吐(PONV)的影响。方法选择2016年3月至2017年2月在北京大学第一医院接受全身麻醉下妇科腹腔镜手术的患者228例。根据患者在手术日处于月经周期的不同阶段分为卵泡期(n=98)、排卵期(n=79)和黄体期(n=51)。收集围术期资料,记录术后0~2h、0~24h内恶心呕吐的发生情况。采用Logistic回归模型分析月经周期不同阶段对PONV发生率的影响。结果术后0~2h有53例(23.2%)患者发生PONV,0~24h有125例(54.8%)PONV。单因素分析显示:月经周期不同阶段PONV发生率差异无统计学意义。多因素Logistic回归分析显示:手术时间>1h(OR=3.176,95%CI 1.567~6.436,P=0.001)、PONV史(OR=5.711,95%CI 1.710~19.080,P=0.005)是术后0~2h恶心呕吐的独立危险因素;手术时间>1h(OR=2.577,95%CI 1.460~4.549,P=0.001)、术后使用PCA泵(OR=2.671,95%CI 1.224~5.831,P=0.014)、术后应用甲硝唑(OR=2.728,95%CI 1.413~5.267,P=0.003)是术后0~24h恶心呕吐的独立危险因素。结论月经周期不同阶段对妇科腹腔镜手术后恶心呕吐的发生率无明显影响。 Objective To investigate the effect of the different phases of menstrual cycle on the incidence of post-operative nausea and vomiting（PONV）after laparoscopic gynecological surgeries.Methods A total of 228 women undergoing laparoscopic gynecological surgeries were enrolled from Mar 2016 to Feb 2017 in our hospital.They were classified into three groups according to the different phases of menstrual cycle at the time of surgeries：group follicular phase（n=98）,group ovulatory phase（n=79）,and group luteal phase（n=59）.The incidence of PONV and the use of rescue antiemetic drugs were recorded within 0-2h,0-24 hperiods after surgeries.Multivariate Logistic regression analysis was applied to identify independent risk factors of PONV.Results The incidence of 0-2hPONV and 0-24 hPONV were 23.2%（53/228）and 54.8%（125/228）respectively.Univariate analysis showed that the incidence of PONV in the different phases of menstrual cycle was not statistically significant,as well as 0-24 h.Multivariate logistic regression analysis showed that the risk of 0-2hPONV in group luteal phase might be higher than that in group follicular phase,however,the difference was not statistically significant（OR=2.289,95%CI 0.979-5.355,P=0.056）.And two independent risk factors of 0-2hPONV were identified：duration of operation〉1h（OR=3.176,95%CI 1.567-6.436,P =0.001）and history of PONV（OR =5.711,95%CI 1.710-19.080,P=0.005）.Three independent risk factors of 0-24 hPONV were identified：duration of operation〉1h（OR =2.714,95%CI 1.525-4.829,P =0.001）,postoperative PCA（OR =2.717,95%CI 1.233-5.986,P =0.013）and application of metronidazole（OR =3.926,95%CI 1.808-8.527,P=0.001）.Conclusion There was no significant effect of different phases of menstrual cycle on the incidence of nausea and vomiting after gynecologic laparoscopic surgeries.

作者李纯青王东信曲元 LI Chunqing WANG Dongxin QU Yuan.(Department of Anesthesia, Peking University First Hospital, Beijing 100034, China)

机构地区北京大学第一医院麻醉科

出处《临床麻醉学杂志》 CAS CSCD 北大核心 2017年第9期842-847,共6页 Journal of Clinical Anesthesiology

关键词术后恶心呕吐月经周期妇科腹腔镜手术 Post-operative nausea and vomiting Menstrual cycle Laparoscopic gynecological surgery

分类号 R614 [医药卫生—麻醉学]

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