摘要目的? 调查脊柱侧凸矫形术患儿术后恶心呕吐(PONV)的发生现状,探讨其影响因素,为临床护理干预提供依据.方法? 便利抽取2017年6月－2018年12 月在中国医学科学院北京协和医院骨科住院并行脊柱侧凸矫形手术的脊柱侧凸矫形患儿417例,记录PONV发生情况,收集其一般资料、疾病资料及手术情况,采用Logistic回归分析脊柱侧凸矫形术后患儿PONV的影响因素.结果? 术后24 h内282例(67.63%)患儿发生PONV,早期PONV为221例,晚期PONV为61例.单因素分析显示,患儿年龄、脊柱侧凸类型、患儿PONV或晕动症史、侧凸矫形改善率、术后使用自控镇痛泵、术前禁食时间、手术时间及患儿血红蛋白变化值不同的患儿24 h内是否发生PONV差异有统计学意义(P＜0.05);Logistic回归分析显示,手术时间、患儿年龄、侧凸矫形改善率、血红蛋白变化值、禁食时间、PONV史或晕动症史是患儿发生PONV的影响因素(P＜0.05).结论? 脊柱侧凸矫形术后患儿PONV发生率较高,护理人员应充分评估患儿PONV的风险,尽量缩短患儿术前禁食时间,重点关注具有PONV高危因素的患儿,采取预防措施以减少或避免患儿PONV的发生.

abstractsObjective To investigate the postoperative nausea and vomiting (PONV) in scoliosis children and to explore its influencing factors so as to provide a basis for clinical nursing intervention. MethodsFrom June 2017 to December 2018, we selected 417 scoliosis children with orthopedic surgery in Orthopedics Department at Chinese Academy of Medical Sciences & Peking Union Medical College Hospital by convenience sampling. The incidence of PONV, general information, disease data and surgery were collected and Logistic regression was used to analyze the influencing factors of PONV in children undergoing scoliosis orthopedic surgery. ResultsThere were 282 (67.63%) children with PONV within 24 hours after surgery including 221 cases in the early stage and 61 in the late stage. Simple correlation showed that there were statistical differences in the incidence of PONV within 24 hours among children with different ages, types of scoliosis, history of PONV or motion sickness of children, improvement rate of scoliosis correction, using of patient-controlled analgesia, fasting time before surgery, surgery time and hemoglobin of children (P＜0.05). Logistic regression showed that the influencing factors of PONV of children included surgery time, ages, improvement rate of scoliosis correction, hemoglobin, fasting time, history of PONV or motion sickness with statistical differences (P＜ 0.05). ConclusionsChildren after scoliosis correction have the high incidence rate of PONV. Nurses should fully assess the risk of PONV in children with the scientific evaluation methods to reduce the fasting time before surgery of children. Nurses should pay more attention to children with high risk of PONV and take measures to reduce and avoid the occurrence of PONV.