研究目的：
手術後噁心嘔吐（PONV）是術後患者的常見副作用。 最近多年來，隨著努力提高醫療品質和關注患者的健康，強化管理的手術後噁心嘔吐。不同的麻醉方法將如何影響手術後噁心嘔吐成為重要的臨床護理問題，值得進一步研究。 然而，在臺灣術後噁心嘔吐的研究有限，本研究旨在應用資料庫分析，試圖找出手術後噁心嘔吐之相關影響因子。
研究方法：
位於臺灣南部的擁有1482張床位的醫學中心收集臨床數據。 麻醉結合電子病歷收集手術後麻醉訪視資料和術前訪視資料2019年7月至2021年6月審查手術後噁心嘔吐的發生率、性別、相關影響因子、科別及滿意度。 此外，結合手術中藥物使用術據做進一步分析用藥效果。
觀察了2021年7月至 2021年12月的記錄，以進一步探索不同手術後噁心嘔吐的麻醉和手術治療。 統計分析包括描述性分析、卡方檢驗和邏輯斯邏輯回歸。 這項研究獲得了臺灣高雄榮民總醫院的IRB批准（KSVGH22–CT4-13）。
研究結果:
從2019年7月至2021年6月，PONV的發病率為 14%，遠低於先前研究的20%至30 %。女性手術後噁心嘔吐發生率約為73.5%，明顯高於在男性（p<0.05）。吸煙狀況和曾經手術後噁心嘔吐病史是影響手術後噁心嘔吐發生的重要因素（p<0.05）。手術後噁心嘔吐在全身麻醉下的發病率為87.41%，脊椎麻醉的發生率為11.32%，而靜脈麻醉率為1.10%（p<0.01）。
研究結論：
本研究為臨床工作人員提供有效的手術後噁心嘔吐麻醉照護策略，提供照護參考辨識手術後噁心嘔吐高危人群及相關措施建議。研究界果提供未來的臨床麻醉護理手術麻醉前、麻醉期間照護參考，以期提升手術患者的醫療品質。

Introduction:
Postoperative nausea and vomiting (PONV) are common side effects for patients after surgery. In recent years, with the efforts to improve the quality of medical care and pay attention to the health of patients, the management of PONV has been strengthened. How different anesthesia approaches will affect PONV becomes an important clinical care issue and is worth further research. Nevertheless, limited study exists in Taiwan. This study aims to apply medical data to investigate such issues in detail.
Methods:
Medical data were collected from a medical center with 1,482 beds located in southern Taiwan. Anesthesia visit data after operation and pre-operation visit information combined with electronic medical records were collected from July 2019 to June 2021 to examine the incidence of PONV after surgery, the effect of satisfaction, and the differences related to genders and surgical departments. In addition, postoperative anesthesia visit data combined with medication records were observed from July 2021 to December 2021 to further explore the potential influences of different anesthesia and surgical treatments on PONV. Statistical analyses include descriptive analyses, the Chi-square test, and logistic regression. This study received IRB approval from the Kaohsiung Veterans General Hospital, Taiwan (KSVGH22–CT4-13).
Results:
The incidence of PONV is 14% from July 2019 to June 2021 which is much lower than previous studies of 20%to 30 %. The incidence of nausea and vomiting in women after surgery is about 73.5% which is significantly higher than in men (p<0.05). Smoking status and previous history of PONV were significant factors that affected PONV occurrence(p<0.05). The incidence rate of PONV for general anesthesia was 87.41%, for spinal anesthesia was 11.32%, and for intravenous anesthesia was 1.10% (p<0.01).

論文審定書 i
致 謝 iii
中文摘要 iv
Abstract v
目錄 vi
圖 目 錄 viii
表 目 錄 ix
第一章 緒論 1
第一節、研究動機與研究問題 1
第二節、研究目的 3
第二章 文獻回顧與探討 4
第一節 手術後噁心嘔吐的的影響 4
第二節 手術後噁心嘔吐相關風險因子探討 7
第三節 降低PONV 風險策略 13
第三章研究方法 20
第一節、研究架構 20
第二節、研究樣本及資料來源 22
第三節、研究變項的操作型定義 24
第四節、研究假設 28
第五節、分析方法 31
第四章 研究結果 32
第一節、樣本描述性統計分析結果 32
第二節、卡方檢定分析相關因子差異性分析 38
第三節、迴歸分析 48
第五章 討 論 52
第一節、手術後噁心嘔吐發生率比較 52
第二節、手術後噁心嘔吐與手術比較 54
第三節、手術後噁心嘔吐與麻醉之相關討論 56
第六章 結論與建議 60
第一節 結論 60
第二節 研究限制 64
第三節 研究貢獻 64
第四節 建 議 65
參考文獻 66
附 錄 69
人體研究計畫同意函 69

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