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find Keyword "日间腹腔镜胆囊切除术" 2 results
  • 日间腹腔镜胆囊切除术多模式镇痛的临床进展

    日间腹腔镜胆囊切除术(ALC)是安全、有效节约资源、提高医院效率的术式,正在逐渐被接受并迅速发展。足够的术后镇痛效果是决定ALC患者术后是否出现疼痛相关并发症、是否可以早期安全离院的重要因素。多模式镇痛是伍用不同镇痛药物或镇痛方法,有效减少伤害刺激及其应激反应,稳定机体内环境,同时较单模式镇痛具有更少副作用,以实现最佳镇痛效果,提高患者术后恢复质量。ALC患者24 h内离院的特殊性,促使国内外ALC围手术期镇痛技术已逐渐由单模式镇痛向多模式镇痛转变。现探讨ALC术后疼痛特点及疼痛产生机制,并对目前ALC多模式镇痛现状及其进展作一综述,进而对其发展趋势进行展望,为临床ALC合理运用多模式镇痛提供参考。

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  • Effect of bundled care on postoperative nausea and vomiting in patients undergoing day laparoscopic cholecystectomy

    Objective To explore whether bundled care for anesthesia management can reduce the risk of postoperative nausea and vomiting (PONV). Methods The data of laparoscopic cholecystectomy patients admitted to the Day Surgery Center of West China Hospital, Sichuan University between July and November 2021 were retrospectively collected. Patients were divided into a bundled care group and a control group based on whether anesthesia management was implemented according to the bundled care. The demographic characteristics, intraoperative anesthesia management methods, postoperative conditions, and incidence of PONV between the two groups of patients were analyzed and compared. Results A total of 314 patients were included. Among them, there were 124 cases in the bundled care group and 190 cases in the control group; PONV occurred in 52 cases, the incidence of PONV was 16.6% (52/314). Except for surgical time and postoperative incision infiltration (P>0.05), there were statistically significant differences in age, gender, body mass index, anesthesia time, airway establishment, and postoperative analgesic use between the two groups of patients (P<0.05). There was no statistically significant difference in the occurrence of PONV between the bundled care group and the control group (17 vs. 35 cases; χ2=1.205, P>0.05). The results of logistic regression analysis showed that PONV was correlated with gender [odds ratio=0.107, 95% confidence interval (0.030, 0.375), P<0.001], and using bundled care [odds ratio=0.388, 95% confidence interval (0.169, 0.894), P=0.026]. Conclusions Women are at high risk of PONV among patients undergoing day laparoscopic cholecystectomy. The risk of PONV is lower when using bundled care.

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