全髋、膝关节置换术病人术后恶心呕吐危险因素的Meta分析

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Abstract  Objective：To systematically evaluate the risk factors of postoperative nausea and vomiting（PONV） in patients with total hip arthroplasty（THA） and total knee arthroplasty（TKA）.Methods：Studies on risk factors of PONV in patients with THA/TKA were retrieved from the Cochrane Library，EMbase， PubMed，Web of Knowledge，CNKI，Wanfang Database and VIP Database.The retrieval period was from establishment of databases to October 22，2021.According to the inclusion and exclusion criteria，two researchers independently screened literature，extracted data and evaluated quality.Review Manager 5.3 software was used for Meta-analysis.Results：A total of 8 articles were included.Meta analysis results showed that women［OR=2.43，95%CI（1.78，3.31），P<0.000 01］，PONV history［OR=5.18，95%CI（2.86，9.37），P<0.000 01］，motion sickness history［OR=4.75，95%CI（2.72，8.29），P<0.000 01］，intraoperative opioids［OR=1.82，95%CI（1.34，2.47），P=0.000 1］，lower BMI［OR=0.70，95%CI（0.60，0.83），P<0.01］，longer operation time［OR=1.02，95%CI（1.01，1.03），P<0.01］，and longer fasting time［OR=1.14，95%CI（1.04，1.24），P<0.01］ were the risk factors for PONV in THA/TKA patients，and intraoperative dexamethasone was the protective factor for PONV in THA/TKA patients［OR=0.40，95%CI（0.28，0.57），P<0.01］.Conclusions：In clinical practice，we should pay attention to the BMI of patients，adopt multimodal analgesia program，reduce intraoperative opioids，and reasonably arrange time of fasting and drinking according to specific operation time of patients to prevent PONV.

Keywords  total hip arthroplasty； total knee arthroplasty； postoperative nausea and vomiting； influencing factors； Meta⁃analysis； evidence⁃based nursing

摘要  目的：系统评价全髋关节置换术（THA）和全膝关节置换术（TKA）病人术后恶心呕吐（PONV）的危险因素。（剩余14761字）