神经外科手术患者术后排气时间影响因素分析

doi:10.3969/j.issn.1006-7795.2021.05.019

摘要/Abstract

摘要： 目的分析神经外科手术患者术后24 h未排气的影响因素,为临床及早给予患者预防与治疗措施,尽快恢复其胃肠功能,提供指导依据。方法将神经外科手术患者分为术后≤24 h排气组和术后>24 h排气组,比较两组患者的一般情况,术中及术后情况。结果纳入的2 446例神经外科手术患者中,>24 h排气组897例(36.7%)。单因素分析显示,在性别(女性vs男性),失血量,是否输注悬浮红细胞,手术时间(≥4 h vs <4 h),术后6 h、24 h静息及功能锻炼后疼痛数字评分(numerical rating scales, NRS)(>3分vs ≤3分),术后6 h、24 h有无恶心呕吐方面,两组患者之间差异有统计学意义(均P<0.05)。二元Logistic回归分析显示,神经外科手术后24 h未排气的独立危险因素有:女性(B=0.333,OR=1.395,P<0.001),手术时间≥4 h(B=0.383,OR=1.467,P<0.001),术后24 h有恶心呕吐(B=0.585,OR=1.794,P<0.001)。结论临床医生需密切关注具有术后24 h未排气独立危险因素(女性、手术时间≥4 h、术后24 h有恶心呕吐)的患者,以加速神经外科手术患者术后胃肠功能恢复。

关键词: 神经外科手术, 排气, 影响因素

Abstract: Objective To analyzes the risk factors of patients who did not exhaust 24 h after neurosurgery, and to provide guidance for early interventions to restore the patients' gastrointestinal function as soon as possible. Methods Patients who underwent neurosurgery were divided into ≤24 h exhaust group and >24 h exhaust group, and their demographics, intraoperative and postoperative details were compared. Results Among the 2 446 patients, 897 (36.7%) did not exhaust 24 h after neurosurgery. The variables associated with this condition in univariate analysis were gender (female vs male), estimated blood loss volume, whether to infuse suspended red blood cells, operation time (≥4 h vs <4 h), numerical rating scales (NRS) scores at rest and during movement at postoperative 6 h and 24 h (>3 vs ≤3), and whether there was nausea and vomiting at postoperative 6 h and 24 h (all P<0.05). Binary Logistic regression analysis showed that female gender (B=0.333, OR=1.395, P<0.001), operation time ≥4 h (B=0.383, OR=1.467, P<0.001), and nausea and vomiting at postoperative 24 h (B=0.585, OR=1.794, P<0.001) were independent risk factors for patients who did not exhaust 24 h after neurosurgery. Conclusion The results in this study suggested the clinicians should pay close attention to patients with independent risk factors (female gender, operation time ≥4 h, and nausea and vomiting at postoperative 24 h) to accelerate the recovery of gastrointestinal function in patients undergoing neurosurgery.

Key words: neurosurgery, exhaust, influencing factors

中图分类号:

R614

苗芳芳, 冯雪辛, 侯瑞雪, 段庆芳, 王天龙. 神经外科手术患者术后排气时间影响因素分析[J]. 首都医科大学学报, 2021, 42(5): 816-821.

Miao Fangfang, Feng Xuexin, Hou Ruixue, Duan Qingfang, Wang Tianlong. Analysis of influencing factors of exhaust time in patients undergoing neurosurgery[J]. Journal of Capital Medical University, 2021, 42(5): 816-821.

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