视频辅助胸部手术食道切除术后术后恶心和吐的危险因素:一项前性队列研究
K Muraoka1,2,3, M Sato4, R Yonezawa3,5
1Division of Pharmacotherapeutics, Department of Clinical Pharmacy, Showa University Graduate School of Pharmacy, Tokyo, Japan.
Die Pharmazie
|March 21, 2024
概括
视频辅助胸部手术食道切除术 (VATS-E) 可能导致术后恶心和吐 (PONV). 高剂量的雷米芬坦尼尔,低的白蛋白和降低的EGFR是PONV在VATS-E之后的关键风险因素.
科学领域:
- 麻醉学 麻醉学
- 胃肠病学 胃肠病学
- 胸部外科手术 胸部外科手术
背景情况:
- 视频辅助胸部手术食道切除术 (VATS-E) 与由于长时间麻醉而导致手术后恶心和吐 (PONV) 的风险有关.
- 之前没有确定VATS-E后PONV的风险因素.
研究的目的:
- 在VATS-E之后确定PONV的独立风险因素.
- 支持针对PONV在VATS-E患者的向风险管理策略.
主要方法:
- 对153名接受VATS-E.E.治疗的患者进行前性队列研究.
- 多变量分析以确定术后24小时内PONV的显著独立风险因素.
- 分析风险因素数量与PONV发病率之间的关联.
主要成果:
- 在153名患者中,PONV的发病率为22.9% (35名).
- 连续性肺炎病毒的独立风险因素包括雷米芬坦尼尔剂量> 89.0 ng/kg/min,白蛋白≤3.5 g/dL,估计的淋巴细胞过率 (eGFR) <60 mL/min/1.73 m2.
- 发现风险因素数量与PONV发病率 (0个因素:5.8%;1个因素:27.3%;≥2个因素:40.0%) 之间存在显著的相关性.
结论:
- 雷米芬坦尼尔剂量,血清白蛋白水平和eGFR是VATS-E后PONV的显著预测因素.
- 识别患有这些风险因素的患者可以进行主动管理,以预防PONV.
- 这些发现可以指导个性化麻醉和术后护理,以减少高风险患者的PONV发病率.
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