肝癌患者术后恶心呕吐发生现况及影响因素研究

doi:10.3761/j.issn.0254-1769.2022.02.009

摘要/Abstract

摘要：

目的探讨肝癌患者术后恶心呕吐的发生情况及影响因素,为临床护理干预提供参考。方法采用连续抽样的方法,选取2020年10月—2021年4月于上海市某三级甲等医院行肝切除手术的肝癌患者为研究对象,研究者分别于术后2 h、6 h、24 h评估患者术后恶心呕吐发生情况,并系统收集患者的一般资料、疾病资料、手术情况、麻醉情况以及术后用药情况,分析术后恶心呕吐的独立影响因素。结果 352例患者中,170例（48.30%）发生术后恶心呕吐,其中,100例（58.82%）发生在术后2 h内,34例（20.00%）发生在术后3~6 h内,36例（21.18%）发生在术后7~24 h。Logistic回归分析显示,女性、晕动史、术后恶心呕吐史、手术时间≥120 min、术中阻断肝门静脉时间≥15 min以及年龄 <60岁是术后恶心呕吐的独立影响因素。结论肝癌患者术后恶心呕吐发生率高,护理人员应重点关注女性、有晕动史和术后恶心呕吐史、手术时间≥120 min、术中阻断肝门静脉时间≥15 min以及年龄<60岁的人群,针对性地高效开展术后恶心呕吐管理,降低其术后恶心呕吐发生率。

关键词: 肝癌, 术后恶心呕吐, 影响因素分析, 护理

Abstract:

Objective To assess the incidence and risk factors of postoperative nausea and vomiting（PONV） in liver cancer patients,and to provide references for clinical nursing intervention. Methods We used consecutive sampling method to select liver cancer patients who underwent liver resection at Zhongshan Hospital of Fudan University from October 2020 to April 2021. A total of 352 patients were prospectively studied. PONV was assessed after 2 hours,6 hours and 24 hours after surgery,respectively. Demographic data,disease information,and surgery information were collected to analyze the risk factors. Results The overall incidence of PONV in liver cancer was 48.30%（170 cases）,of which 58.82%（100 cases） developed within postoperative 2 hours,20.00%（34 cases） developed between 3-6 hours after surgery,and 21.18%（36 cases） developed between 7-24 hours after surgery. Logistic regression identified the female,length of surgery,PONV history or motion sickness history,time of portal vein occlusion≥15 min and age<60 years old as risk factors of PONV. Conclusion The incidence of PONV within 24 hours in liver cancer was high.Nurses should pay much attention to those who were female at a younger age,with longer surgery,PONV or motion sickness history,longer time of portal vein occlusion,and take preventive measures to avoid or reduce PONV.

Key words: Liver Cancer, Postoperative Nausea and Vomiting, Root Case Analysis, Nursing Care

周海英, 张玉侠, 陈潇, 章琪, 朱燕, 俞静娴. 肝癌患者术后恶心呕吐发生现况及影响因素研究[J]. 中华护理杂志, 2022, 57(2): 182-187.

ZHOU Haiying, ZHANG Yuxia, CHEN Xiao, ZHANG Qi, ZHU Yan, YU Jingxian. The incidence and risk factors of postoperative nausea and vomiting in liver cancer[J]. Chinese Journal of Nursing, 2022, 57(2): 182-187.

图/表 3

表1 肝癌患者术后恶心呕吐的单因素分析结果[n=352,例（百分比,%）]

Table 1 Univariate analysis of PONV among patients with liver cancer [n=352,cases（percentages,%）]

表2 自变量赋值方式

Table 2 Independent variable assignment

表3 肝癌患者术后恶心呕吐的 Logistic回归分析结果（n=352）

Table 3 Results of multivariate Logistic regression analysis of factors affecting PONV among patients with liver cancer（n=352）

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