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术前质子泵抑制剂及胃食管反流病对术后恶心呕吐的影响

Effect of a Preoperative Proton Pump Inhibitor and Gastroesophageal Reflux Disease on Postoperative Nausea and Vomiting.

作者信息

Kwon Young Suk, Choi Jun Woo, Lee Ho Seok, Kim Jong Ho, Kim Youngmi, Lee Jae Jun

机构信息

Department of Anesthesiology and Pain Medicine, Chuncheon Sacred Heart Hospital, College of Medicine, Hallym University, Chuncheon 24253, Korea.

Institute of New Frontier Research Team, Hallym University, Chuncheon 24253, Korea.

出版信息

J Clin Med. 2020 Mar 18;9(3):825. doi: 10.3390/jcm9030825.

DOI:10.3390/jcm9030825
PMID:32197451
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC7141242/
Abstract

Postoperative nausea and vomiting (PONV) are common complications after anesthesia, but no study has considered the effects of a proton pump inhibitor (PPI) and gastroesophageal reflux disease (GERD) on PONV at the same time. Thus, we investigated the effects of a PPI and GERD on PONV. Patients aged ≥18 years who underwent general anesthesia between 2010 and 2019 were enrolled. In total, 202,439 patients were included and 21,361 In a multivariate analysis, the OR for PONV was higher in subjects with GERD (OR, 1.157; 95% CI, 1.032-1.298; = 0.012). The OR was lower for subjects with taking a PPI (OR, 0.890; 95% CI, 0.832-0.953; < 0.0001). In patients without GERD, the incidence of PONV was lower when lansoprazole (OR, 0.801; 95% CI, 0.718-0.894; < 0.0001), pantoprazole (OR, 0.856; 95% CI, 0.748-0.980; = 0.025) and ilaprazole (OR, 0.391; 95% CI, 0.158-0.966; = 0.042) were taken. However, in GERD patients, all PPIs did not show reducing the incidence of PONV. Taken together, the results show that a lansoprazole, pantoprazole, and ilaprazole reduced PONV in patients without GERD, and PPI could not reduce PONV in patients with GERD.

摘要

术后恶心呕吐(PONV)是麻醉后常见的并发症,但尚无研究同时考虑质子泵抑制剂(PPI)和胃食管反流病(GERD)对PONV的影响。因此,我们研究了PPI和GERD对PONV的影响。纳入了2010年至2019年间接受全身麻醉的≥18岁患者。总共纳入了202439例患者,其中21361例……在多因素分析中,GERD患者发生PONV的比值比(OR)较高(OR为1.157;95%置信区间为1.032 - 1.298;P = 0.012)。服用PPI的患者OR较低(OR为0.890;95%置信区间为0.832 - 0.953;P < 0.0001)。在无GERD的患者中,服用兰索拉唑(OR为0.801;95%置信区间为0.718 - 0.894;P < 0.0001)、泮托拉唑(OR为0.856;95%置信区间为0.748 - 0.980;P = 0.025)和艾普拉唑(OR为0.391;百分之95%置信区间为0.158 - 0.966;P = 0.042)时,PONV的发生率较低。然而,在GERD患者中,所有PPI均未显示出降低PONV的发生率。综上所述,结果表明兰索拉唑、泮托拉唑和艾普拉唑可降低无GERD患者的PONV发生率,而PPI不能降低GERD患者的PONV发生率。 (注:原文中“21,361 In a multivariate analysis”部分似乎不完整,翻译时保留了原文表述)

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/49f0/7141242/d296e5e023a9/jcm-09-00825-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/49f0/7141242/dd5d1d0d0024/jcm-09-00825-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/49f0/7141242/d296e5e023a9/jcm-09-00825-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/49f0/7141242/dd5d1d0d0024/jcm-09-00825-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/49f0/7141242/d296e5e023a9/jcm-09-00825-g002.jpg

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