全凭静脉麻醉下经内镜逆行胰胆管造影术后恶心呕吐的危险因素

Risk factors for postoperative nausea and vomiting after endoscopic retrograde cholangio pancreatography under total intravenous anesthesia

中文关键词: 经内镜逆行胰胆管造影术  术后恶心呕吐  危险因素

英文关键词: Endoscopic retrograde cholangio pancreatography  Postoperative nausea and vomiting  Risk factors

中文摘要:

      目的 筛选全凭静脉麻醉下经内镜逆行胰胆管造影术(endoscopic retrograde cholangio pancreatography,ERCP)术后恶心呕吐(postoperative nausea and vomiting, PONV)的独立危险因素。方法 选择上海瑞金医院2016年7月18日至8月31日全凭静脉麻醉下行ERCP的患者90例,男47例,女43例,年龄≥18岁,ASA Ⅰ～Ⅲ级。收集患者的一般资料和术中情况,随访术后24 h内恶心呕吐的发生情况。采用Logistic回归分析全凭静脉麻醉下ERCP术后恶心呕吐的独立危险因素。结果 有33例(36.7％)患者发生恶心。进一步Logistic回归分析结果显示,女性(OR=3.73,95％CI 1.36～10.27)、有PONV/晕动症史(OR=4.39,95％CI 1.40～13.76)、术后3 h血淀粉酶>3倍正常值(OR=5.22,95％CI 1.30～20.95)是全凭静脉麻醉下ERCP术后恶心呕吐的独立危险因素。结论 女性、有PONV/晕动症史、术后3 h血淀粉酶>3倍正常值是全凭静脉麻醉下ERCP术后恶心呕吐的独立危险因素。

英文摘要:

      Objective To determine the independent risk factors for postoperative nausea and vomiting (PONV) after endoscopic retrograde cholangio pancreatography (ERCP) under total intravenous anesthesia. Methods Ninety patients, 47 males and 43 females, aged 18 years old or more, falling into ASA physical status Ⅰ Ⅲ, undergoing ERCP under total intravenous anesthesia from July 18, 2016 to August 31, 2016 in Ruijin Hospital were included in our study. General information and intraoperative situation of patients were collected. The incidence of PONV within 24 h was recorded. A multivariate Logistic regression model was performed to analyze the independent risk factors of PONV after ERCP under total intravenous anesthesia. Results In total, 90 patients were included in this study, with 33 patients (36.7%) suffering PONV. Logistic analyses showed that female (OR=3.73, 95%CI 1.36-10.27), history of PONV/motion sickness(OR=4.39, 95%CI 1.40-13.76), and serum amylase greater than 3 times the normal value (OR=5.22, 95%CI 1.30-20.95) were the independent risk factors for PONV after ERCP under total intravenous anesthesia. Conclusion Female, history of PONV/motion sickness, and serum amylase greater than 3 times the normal value were the independent risk factors for PONV after ERCP under total intravenous anesthesia.