门诊美容手术后呕吐发生相关因素分析及预防.docVIP

门诊美容手术后呕吐发生相关因素分析及预防 　　[摘要]目的：探讨美容手术术后呕吐（postoperative vomiting,POV）发生的原因及预防措施。方法：回顾自2004年7月～2007年5月1 469例门诊美容手术病历，分析性别、手术术式、术中用药和术后用药等因素对POV发生率的影响。结果：POV主要发生在隆乳、脂肪抽吸、面颈部除皱和多个手术联合实施的手术后，而手术时间在1h左右完成的单个手术，术后无呕吐发生。女性呕吐的发生率明显高于男性。术中应用镇痛药物者，POV发生率高，其中应用哌替啶者POV发生率明显高于使用芬太尼者。术前使用甲氧氯普胺可明显降低药物引起的早期呕吐，但对手术8h以后的POV发生率无明显影响。手术8h以后出现呕吐者中，血肿发生率高，瘀血严重。呕吐发生后再应用甲氧氯普胺治疗无效。结论：门诊美容手术后呕吐的发生主要和性别、手术中镇痛药物的使用以及手术后术区瘀血量有关。术前应用甲氧氯普胺可防止药物引起的术后早期呕吐，但对可能因瘀血引发的术后晚期出现呕吐无预防效果。 　　[关键词]美容外科手术；手术后呕吐；甲氧氯普胺 　　[中图分类号]R622[文献标识码]A[文章编号]1008-6455（2007）03-03 　　 　　Retrospective study of postoperative vomiting following cosmetic surgery 　　YANG Yong,YU Jing,WANG Lan,LI Jing 　　(Bioscor Medical and Cosmetic Clinic of Shanghai,Shanghai 200031,China) 　　 　　Abstract: Objective To explore some probably reasons and prophylaxisof postoperative vomiting(POV) following a cosmetic surgery.MethodsA retrospective study was carried out in 1469 cases who had underwent cosmetic surgery from July 2004 to May 2007.Relative risk factors for POV included sex, duration of surgery,drugs used during and after surgery. Results POV was fined in the surgery of breast augmentation, liposuction, face and neck lifting and multi-surgery.No POV happened in the case of surgery time less than an hour. Happening rate of POV was higher in female than that in male. Pain killer, especially pethidine, could make the rate of POV higher.Prophylactic use of metoclopramide could decrease the rate of POV happening within 8 hours after surgery. But it had no effect on the POV happening 8 hours after surgery. Hematoma or severe bruise was seen in the case of POV beginning from 8h after surgery.When POV was happened, no medicine could stop it. Conclusion The relative risk factors for POV was sex, duration of surgery, pain killer used during surgery and volume of blood accumulated in surgery area. Prophylactic use of metoclopramide had benefit effect on POV caused by using of pain killer. 　　Key words: cosmetic surgery;postoperative vomiting(POV