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妊娠剧吐产妇剖宫产术后恶心呕吐的发生率：回顾性队列研究
翻译：何幼芹 编辑：冯玉蓉 审校：曹莹
背景及目的：术后恶心呕吐是剖宫产最常见的麻醉并发症之一。本研究旨在探索妊娠剧吐与剖宫产后恶心呕吐的关系。
方法：采用电子数据库对2015-2019年接受剖宫产手术的妊娠剧吐产妇和非妊娠剧吐产妇进行单中心回顾性队列研究。通过回顾术后24h内应用止吐药物的使用情况，确定术后恶心呕吐的发生率和严重程度，并采用单因素、多变量二元和有序Logistic回归模型进行检验。
结果：本研究共比较了76例妊娠剧吐产妇和315例非妊娠剧吐产妇的数据资料。妊娠剧吐组术后恶心呕吐发生率为43.4%，非妊娠剧吐组为29.6%。妊娠剧吐产妇术后恶心呕吐的发生率是无妊娠剧吐妇女的1.95倍(aOR:1.95，95%CI:1.13~3.36，P=0.016)。妊娠剧吐组术后出现较严重恶心呕吐的机率较大(aOR:1.91，95%CI:1.14~3.20，P=0.014)。
结论：妊娠剧吐产妇在剖宫产后更容易出现恶心和呕吐，其程度甚至可能比非妊娠剧吐产妇更重。这一发现有助于为剖宫产妊娠剧吐产妇提供术中和术后有效的止吐。
原始文献来源：Jacobs NF, Veronese LR, Okano S, et al. The incidence of postoperative nausea and vomiting after caesarean section in patients with hyperemesis gravidarum: a retrospective cohort study.[J] .Int J Obstet Anesth, 2020, 44: 81-89.
The incidence of postoperative nausea and vomiting after caesarean section in patients with hyperemesis gravidarum: a retrospective cohort study
ABSTRACT
Background: Postoperative nausea and vomiting is one of the most common anaesthetic complications of caesarean section. This study examined the association between hyperemesis gravidarum during pregnancy and nausea and vomiting after caesarean section.
Methods: A single-centre, retrospective cohort study, using electronic databases of patients, with and without hyperemesis gravidarum, undergoing caesarean section from 2015 to 2019. The incidence and severity of postoperative nausea and vomiting were established by a review of the documentation of administration of postoperative anti-emetics within the 24-h period after surgery, and examined using univariable, multivariable binary and ordered logistic regression models.
Results: Data were compared for 76 patients with hyperemesis gravidarum and 315 patients without the condition. The incidence of postoperative nausea and vomiting in the hyperemesis group versus the non-hyperemesis group was 43.4% and 29.6%, respectively. The odds of experiencing postoperative nausea and vomiting was 1.95 times higher in women with hyperemesis gravidarum than in those without (aOR 1.95, 95% CI 1.13 to 3.36, P=0.016). The odds of having more severe postoperative nausea and vomiting were greater in the hyperemesis gravidarum group (aOR 1.91, 95% CI 1.14 to 3.20, P=0.014).
Conclusion: Patients with hyperemesis gravidarum are more likely to develop nausea and vomiting after caesarean section, and this is likely to be of greater severity than in those without the condition. This finding should assist the effective provision of intra-operative and postoperative anti-emetics for patients with hyperemesis gravidarum undergoing caesarean section.
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