摘要
目的 系统筛查全麻术后恶心呕吐（PONV）的关键危险因素，基于危险因素构建多维度协同干预策略。方法 选取2025年1月-2025年6月本院行全麻手术的100例患者为研究对象，随机分为对照组与实验组各50例。对照组采用PONV常规预防干预；实验组先通过临床基线资料分析明确PONV危险因素，再针对性构建“术前风险分层-术中精准调控-术后动态管理”多维度协同干预策略。比较两组PONV发生率、视觉模拟恶心呕吐评分（VAS-NV）及症状持续时间。结果 实验组PONV发生率为显著低于对照组（χ²=7.862，P=0.005）；实验组术后24h VAS-NV评分显著低于对照组（t=10.568，P＜0.001）；实验组症状持续时间显著短于对照组（t=13.421，P＜0.001）。结论 全麻术后恶心呕吐受多种因素协同影响，基于危险因素构建的多维度协同干预策略可显著降低PONV发生率，减轻症状严重程度，缩短持续时间，防控效果确切，具备临床推广价值。
关键词： 全身麻醉；术后恶心呕吐；危险因素；多维度干预；精准防控
Abstract
Objective To systematically screen the key risk factors for postoperative nausea and vomiting (PONV) under general anesthesia, and to construct a multidimensional collaborative intervention strategy based on these risk factors. Methods 100 patients who underwent general anesthesia surgery in our hospital from January 2025 to June 2025 were selected as the study subjects and randomly divided into a control group and an experimental group, with 50 patients in each group. The control group received routine preventive intervention with PONV; In the experimental group, risk factors for PONV were first identified through analysis of clinical baseline data, and then a targeted multidimensional collaborative intervention strategy was constructed and implemented. Results The incidence of PONV in the experimental group was significantly lower than that in the control group (χ²=7.862, P=0.005); The VAS-NV score of the experimental group was significantly lower than that of the control group 24 hours after surgery (t=10.568, P<0.001); The duration of symptoms in the experimental group was significantly shorter than that in the control group (t=13.421, P<0.001). Conclusion Postoperative nausea and vomiting under general anesthesia are influenced by multiple factors. A multidimensional collaborative intervention strategy based on risk factors can significantly reduce the incidence of PONV, alleviate the severity of symptoms, shorten the duration, and have definite prevention and control effects. It has clinical promotion value.
Key words： General anesthesia; Postoperative nausea and vomiting; Risk factors; Multidimensional intervention; Precise prevention and control
参考文献 References
[1] 沙甜甜,王海浪,熊苗苗,等.艾司氯胺酮介导的阿片节俭策略对腹腔镜子宫全切术后恶心呕吐发生率的影响[J].国际麻醉学与复苏杂志,2025,46(10):1052-1057.
[2] 杨博,高慧.咀嚼口香糖治疗全麻术后咽痛的研究进展[J].临床医学进展,2025,15(9):5.
[3] 戴拥,刘清,吴港发.经皮穴位电刺激对全麻腹腔镜胆囊切除术患者术后恶心呕吐的防治效果观察[J].湖南中医杂志,2025,41(3):6-10.
[4] 韩雨佳,孙昕培,祁钰杰,等.血流动力学监测仪指导目标导向液体治疗对妇科腹腔镜手术患者术后恶心呕吐的影响因素研究[J].中国医学装备,2024,21(1):123-129.
[5] 刘瑞娟.异丙嗪联合甲氧氯普胺防治结直肠肿瘤患者术后恶心呕吐的作用研究[D].宁夏医科大学,2023.
[6] 吴文春,董敏,陈莹昊,等.姜辣素穴位敷贴对全麻患者术后恶心呕吐的作用及机制[J].贵州医科大学学报,2023, 48(11):1406-1410.
[7] 赵薇.昂丹司琼防治术前焦虑患者术后恶心呕吐的效果观察[D].昆明理工大学,2023.
[8] 许际平,丁琳,胡丽华,等.内关-外关透刺针法对麻醉诱导期血流动力学及术后恶心呕吐的影响[J].中国实用医药,2025,20(11):1-6.