摘要
目的研究预防性给予止吐药物的妇科患者发生术后恶心呕吐(PONV)的危险因素。方法选择行妇科手术的患者1 000例,收集患者基本资料以及麻醉、手术和其他资料,并于术后第1天进行恶心呕吐的调查随访,对数据进行统计学分析。结果多因素logistic回归分析纳入晕动病史、镇痛泵、麻醉时长、术毕应用新斯的明,按OR值从大到小排序为晕动病史(OR=1.953,95%CI:1.404~2.716)、术毕应用新斯的明(OR=1.831,95%CI:1.203~2.786)、镇痛泵(OR=1.472,95%CI:1.017~2.129)、麻醉时长(OR=1.256,95%CI:1.058~1.492),预测模型为p=1(1+e^(1.623-0.669x-1-0.386x_2-0.228x_3-0.605x_4))。此模型判断妇科患者PONV的准确度为70.6%,预测结果ROC曲线下面积为0.642。结论预防性给予止吐药物的妇科患者发生PONV的独立危险因素按影响程度由大到小为晕动病史、术毕应用新斯的明、镇痛泵、麻醉时长。
Objective To study the risk factors for postoperative nausea and vomiting （PONV） in gynecological patients administered prophylactic antiemetics. Methods A total of 1 000 gynecological surgical cases were reviewed. Data on patient characteristics,anesthesia,surgeries,and 1st postoperative day nausea and vomiting were collected and analyzed statistically. ResuLts Multivariate logistic regression analysis included a history of motion sickness, the use of an analgesic, pump, the duration of anesthesia, and the use of neostig- mine. The odds ratios （ORs）,in decreasing order,were that of a history of motion sickness [OR = 1.953,95% confidence interval （C1） ： 1.404 -2.716J,the use of neostigmine （OR = 1.831,95% CI： 1.203 -2.786）,the use of an analgesic pump （OR = 1.472,95% CI： 1,017- 2.129）, and the duration of anesthesia （OR = 1.256,95% Ch 1.058 - 1.492）. The predictive model was described by the following equation：p=1（1＋e1.623-0.669x-1-0.386x2-0.228x3-0.605x4）. the predictive accuracy of this model for the incidence of PONV in gynecological patients was 70.6%,and the area under the receiver operating characteristic curve for the predictive result was 0.642. Conclusion The independent risk factors for PONV in gynecological patients administered prophylactic antiemeties are a history of motion sickness,the use of neostig- mine, the use of an analgesic pump, and the duration of anesthesia, in decreasing order of significance.
出处
《中国医科大学学报》
CAS
CSCD
北大核心
2017年第11期1032-1035,1044,共5页
Journal of China Medical University
关键词
术后恶心呕吐
妇科手术
LOGISTIC回归分析
postoperative nausea and vomiting
gynecological surgery
logistic regression analysis
