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血清胃蛋白酶原水平升高可预测肥胖女性腹腔镜袖状胃切除术后的恶心呕吐和疼痛。

Elevated serum pepsinogen level predicts postoperative nausea and vomiting and pain in females with obesity following laparoscopic sleeve gastrectomy.

作者信息

Hou Min, Wu Lina, Wei Zhuoqi, Jiang Shuwen, Wang Huaxi, Chen Wenhui, Hu Ruixiang, Guan Bingsheng, Cheng Lyujia, Wang Jianxue, Hu Songhao, Wang Cunchuan, Zhang Junchang, Dong Zhiyong, Yang Jingge, Lin Qingran, Yang Wah

机构信息

Department of Metabolic and Bariatric Surgery, The First Affiliated Hospital of Jinan University, Guangzhou, Guangdong Province, China.

School of Nursing; The First Affiliated Hospital, Jinan University, Guangzhou, Guangdong Province, China.

出版信息

Int J Obes (Lond). 2025 Apr;49(4):665-672. doi: 10.1038/s41366-024-01688-z. Epub 2024 Nov 28.

Abstract

BACKGROUND

Postoperative nausea and vomiting (PONV) is the most common side effect after laparoscopic sleeve gastrectomy (LSG), affecting patients' postoperative recovery and increasing the medical and economic burden. This study aimed to analyze the relationship between serum pepsinogen and PONV.

METHODS

Patients with obesity who underwent LSG in our center between January 2021 and December 2022 were divided into PONV and NoPONV groups and analyzed retrospectively. Binary logistic regression analysis was used to determine the independent risk factors for PONV.

RESULTS

219 female patients were enrolled, with an average BMI of 36.74 ± 8.34 kg/m and aged 32.61 ± 6.18 years. PONV occurred in 157 patients (71.7%). The influencing factors of PONV with different severity were analyzed, and the results showed that the severity of postoperative pain (χ2 = 13.169, p-values = 0.004), PGI (χ2 = 14.625, p-values = 0.002), PGII (χ2 = 25.916, p-values = 0.000), and PGR (χ2 = 17.697, p-values = 0.001) had statistical significance. Binary logistic regression showed that PGI was a risk factor for PONV with a OR (ng/mL) value of 1.013 (95% CI: 1.001-1.024, p-values = 0.037), while PGR was a protective factor for PONV with an OR(ng/mL) value of 0.952 (95% CI: 0.925-0.979, p-values = 0.001).

CONCLUSIONS

The incidence of PONV after LSG is high. Higher PGI may be a risk factor for promoting PONV after LSG. The higher the preoperative PGI, the later the onset of PONV; the longer the duration, the more serious the degree.

摘要

背景

术后恶心呕吐(PONV)是腹腔镜袖状胃切除术(LSG)后最常见的副作用,影响患者术后恢复,并增加医疗和经济负担。本研究旨在分析血清胃蛋白酶原与PONV之间的关系。

方法

回顾性分析2021年1月至2022年12月在本中心接受LSG的肥胖患者,将其分为PONV组和无PONV组。采用二元逻辑回归分析确定PONV的独立危险因素。

结果

共纳入219例女性患者,平均BMI为36.74±8.34kg/m,年龄为32.61±6.18岁。157例患者(71.7%)发生PONV。分析了不同严重程度PONV的影响因素,结果显示术后疼痛严重程度(χ2=13.169,p值=0.004)、PGI(χ2=14.625,p值=0.002)、PGII(χ2=25.916,p值=0.000)和PGR(χ2=17.697,p值=0.001)具有统计学意义。二元逻辑回归显示,PGI是PONV的危险因素,OR(ng/mL)值为1.013(95%CI:1.001-1.024,p值=0.037),而PGR是PONV的保护因素,OR(ng/mL)值为0.952(95%CI:0.925-0.979,p值=0.001)。

结论

LSG后PONV的发生率较高。较高的PGI可能是促进LSG后PONV的危险因素。术前PGI越高,PONV发生越晚;持续时间越长,程度越严重。

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