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.
目的 了解成都市围孕期妇女的孕前保健认知度及需求状况。 方法 2011年7月－2012年1月对成都市225名初产孕妇为调查对象，采用访谈及问卷进行调查，回收有效问卷217 份。 结果 217名中仅13名进行了孕前保健，孕前保健的参与率较低（5.99%）；孕妇的年龄和受教育程度对孕前保健的认知度、参与率比较差异有统计学意义（P＜0.05）；孕前小剂量叶酸服用率11.20%，但正确服用率仅为1.50%。48.84%（106/217）听说过孕前保健，其中36.79%（39/106）知道孕前保健的最佳时间，但不完全了解孕前保健内容；55.67%（59/106）的夫妇知道需在孕前改变不良生活方式；21.69%（23/106）知道部分孕前检查内容，44.34%（47/106）知晓孕前补充小剂量叶酸预防神经管缺陷，仅3.77%（4/106）知道孕前遗传咨询。获取知识途径依次为网络22.64%（24/106），社区宣传或讲座24.53%（26/106），朋友同事33.96%（36/106），医院15.09%（16/106），书刊和广告3.77%（4/106），但仅10.10%的妇女是通过培训渠道获取的知识。高达89.40%的妇女迫切希望参加孕前保健及相关预防出生缺陷的知识培训，并希望去社区或妇幼专科医院接受相关孕前咨询及检查。 结论 成都市围孕期妇女孕前保健认知度较低，导致孕前保健的参与率较低、依从性较差，叶酸服用率低而不规范；孕前保健知识培训及服务形式、内容急待增强。围孕妇女孕前保健需求较高，倾向价廉、便捷的社区医院和妇幼专科医院。