肥胖患者腹腔镜袖状胃切除术后恶心呕吐发生情况及危险因素分析OA

Objective To investigate the incidence and risk factors of postoperative nausea and vomiting(PONV)in patients with obesity who underwent laparoscopic sleeve gastrectomy(LSG).Methods A retrospective analysis was conducted on the clinical data of 156 obese patients who underwent LSG from April 2019 to April 2024.The occurrence of PONV was statistically analyzed,and multivariate logistic regression was used to investigate the risk factors for PONV in obese patients treated with LSG.Results Among the 156 obese patients who underwent LSG,41 patients(26.28%)developed PONV.These patients were included in the PONV group,while the remaining patients were included in the non-PONV group.The PONV group had more females,a higher proportion of intraoperative Sufentanil use,and higher preoperative levels of alanine aminotransferase(ALT),aspartate aminotransferase,and C-reactive protein(CRP)compared with the non-PONV group,but a lower proportion of intraoperative Dexmedetomidine use and preoperative follicle-stimulating hormone(FSH)levels,as compared with those in the non-PONV group(P<0.05).Female gender,intraoperative Sufentanil use,and elevated preoperative ALT levels were all risk factors for PONV in obese patients treated with LSG,while intraoperative Dexmedetomidine use was a protective factor(P<0.01).Conclusion In clinical practice,for high-risk populations(especially women and those with abnormal liver function),the anesthesia plan should be optimized to reduce the dosage of Opioids,appropriately apply Dexmedetomidine,and combine multimodal antiemetic strategies to lower the risk of PONV in obese patients undergoing LSG and improve the quality of postoperative recovery.