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比较预防性方案在减少肺癌电视辅助胸腔镜根治性切除术中围手术期恶心和呕吐的疗效。

Comparative efficacy of prophylactic protocols in reducing perioperative nausea and vomiting during video-assisted thoracoscopic radical resection of lung cancer.

机构信息

Department of Thoracic Surgery, Fujian Medical University Union Hospital, Fuzhou, China.

Key Laboratory of Ministry of Education for Gastrointestinal Cancer, Fujian Medical University, Fuzhou, China.

出版信息

Sci Rep. 2024 Apr 29;14(1):9818. doi: 10.1038/s41598-024-59687-z.

DOI:10.1038/s41598-024-59687-z
PMID:38684769
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11059372/
Abstract

Lung cancer, a global mortality leader, often necessitates Video-Assisted Thoracoscopic (VATS) surgery. However, post-operative nausea and vomiting (PONV) is common, highlighting a need for effective management and prevention strategies in this context. A retrospective case-control study at Fujian Medical University Union Hospital evaluated patients undergoing VATS radical resection of lung cancer between May and September 2022. Patients were categorized based on PONV prevention methods, and data encompassing demographics, surgical history, and postoperative adverse events s were analyzed to assess the association between prophylactic protocols and PONV incidence. The Netupitant and Palonosetron Hydrochloride (NEPA) group showed a significant reduction in PONV occurrences post-surgery compared to Ondansetron (ONDA) and Control groups, emphasizing NEPA's efficacy in alleviating PONV symptoms (P < 0.05). Furthermore, following VATS radical resection of lung cancer, NEPA markedly reduced the intensity of PONV symptoms in patients. Both univariate and multivariate logistic analyses corroborated that NEPA independently reduces PONV risk, with its protective effect also apparent in susceptible populations like females and non-smokers. NEPA utilization markedly reduced both the incidence and severity of PONV in patients undergoing VATS radical resection of lung cancer, serving as an independent protective factor in mitigating PONV risk post-surgery.

摘要

肺癌是全球死亡率的主要原因之一,常需要进行电视辅助胸腔镜(VATS)手术。然而,术后恶心和呕吐(PONV)很常见,这凸显了在这种情况下需要有效的管理和预防策略。福建医科大学附属协和医院的一项回顾性病例对照研究评估了 2022 年 5 月至 9 月期间接受 VATS 肺癌根治性切除术的患者。根据 PONV 预防方法对患者进行分类,并分析了包括人口统计学、手术史和术后不良事件在内的数据,以评估预防方案与 PONV 发生率之间的关联。与昂丹司琼(ONDA)组和对照组相比,奈妥匹坦和帕洛诺司琼盐酸盐(NEPA)组术后 PONV 发生率显著降低,表明 NEPA 缓解 PONV 症状的有效性(P<0.05)。此外,在接受肺癌 VATS 根治性切除术后,NEPA 显著降低了患者 PONV 症状的强度。单因素和多因素逻辑分析均证实,NEPA 独立降低 PONV 风险,其保护作用在女性和非吸烟者等易感人群中也很明显。NEPA 的使用显著降低了接受 VATS 肺癌根治性切除术患者的 PONV 发生率和严重程度,是减轻术后 PONV 风险的独立保护因素。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/925e/11059372/b1c04f28ade2/41598_2024_59687_Fig4_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/925e/11059372/ad172f860269/41598_2024_59687_Fig1_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/925e/11059372/5aeeaefe30ce/41598_2024_59687_Fig2_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/925e/11059372/fcb2e1fa3152/41598_2024_59687_Fig3_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/925e/11059372/b1c04f28ade2/41598_2024_59687_Fig4_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/925e/11059372/ad172f860269/41598_2024_59687_Fig1_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/925e/11059372/5aeeaefe30ce/41598_2024_59687_Fig2_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/925e/11059372/fcb2e1fa3152/41598_2024_59687_Fig3_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/925e/11059372/b1c04f28ade2/41598_2024_59687_Fig4_HTML.jpg

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