术后恶心呕吐防治的研究新进展

New Research Progress in Prevention and Treatment of Postoperative Nausea and Vomiting

摘要: 术后恶心呕吐(Postoperative Nausea and Vomiting, PONV)是围手术期最常见的并发症之一，普通手术人群发生率约为20%~30%，高危人群可达70%~80%。该并发症显著延长住院时间、增加医疗成本、降低患者满意度，严重时可引发误吸、电解质紊乱、切口裂开等不良事件。近年来，随着发病机制研究的不断深入、新型药物与非药物干预手段的持续迭代以及多模式防治与精准化管理理念的广泛普及，PONV的防治已步入规范化、个体化及中西医协同发展的新阶段。本文将从西医防治进展与中医防治进展两大核心维度出发，围绕风险评估、药物干预、麻醉与围术期优化、非药物疗法、特殊人群管理、中西医结合模式及机制研究等方面展开全面综述，并补充了近三年高被引英文文献，以期为临床构建安全、高效且可复制的PONV防治体系提供循证依据。

Abstract: Postoperative Nausea and Vomiting (PONV) is one of the most common perioperative complications. The incidence of PONV is about 20%~30% in the general surgical population and 70%~80% in the high-risk population. This complication significantly prolongs hospital stay, increases medical costs, and reduces patient satisfaction. In severe cases, it can cause adverse events such as aspiration, electrolyte imbalance, and incision dehiscence. In recent years, with the deepening of pathogenesis research, the continuous iteration of new drug and non-drug interventions, and the widespread popularization of multi-mode prevention and precise management concepts, the prevention and treatment of PONV has entered a new stage of standardization, individualization and coordinated development of Chinese and Western medicine. This article will start from the two core dimensions of the progress of western medicine prevention and treatment and the progress of traditional Chinese medicine prevention and treatment, and comprehensively review the risk assessment, drug intervention, anesthesia and perioperative optimization, non-drug therapy, special population management, integrated traditional Chinese and Western medicine model and mechanism research, and supplement the highly cited English literature in the past three years, in order to provide evidence-based basis for the clinical construction of a safe, efficient and reproducible PONV prevention and treatment system.