自主神经系统在术后恶心呕吐中的作用机制与干预研究进展
Mechanisms and Intervention Research Progress of the Autonomic Nervous System in Postoperative Nausea and Vomiting
摘要: 术后恶心呕吐(postoperative nausea and vomiting, PONV)是围术期最常见并发症之一,可引发电解质紊乱、误吸、伤口裂开等不良后果,影响患者术后快速康复,增加医疗成本。PONV发生机制复杂,已有研究表明自主神经系统(autonomic nervous system, ANS)可能在其发生发展过程中起到了重要作用。心率变异性(heart rate variability, HRV)是一种无创,可动态反应自主神经功能状态的生理指标,在PONV预测和风险分层中具有潜在价值。本文就ANS在PONV发生中的自主神经机制、HRV在PONV预测中的应用,以及基于ANS调节的防治措施等方面进行综述,旨在为临床提供参考。
Abstract: Postoperative nausea and vomiting (PONV) is one of the most common perioperative complications and can lead to adverse consequences such as electrolyte disturbances, aspiration, and wound dehiscence, thereby compromising enhanced postoperative recovery and increasing healthcare costs. The pathogenesis of PONV is complex, and accumulating evidence suggests that the autonomic nervous system (ANS) may play an important role in its initiation and progression. Heart rate variability (HRV) is a noninvasive physiological metric that can dynamically reflect autonomic function and has potential value in PONV prediction and risk stratification. This review summarizes the autonomic mechanisms of ANS involvement in PONV, the application of HRV in predicting PONV, and preventive and therapeutic strategies based on ANS modulation, with the aim of providing a reference for clinical practice.
文章引用:姜力文, 齐峰. 自主神经系统在术后恶心呕吐中的作用机制与干预研究进展[J]. 临床医学进展, 2026, 16(4): 1243-1254. https://doi.org/10.12677/acm.2026.1641357

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