关键词: 原因, 胰十二指肠切除术, 顽固性呕吐, 护理, CIVIQ生活量表

Abstract: ［Abstract］ Objevtive To investigate the causes and nursing strategies of refractory vomiting after pancreaticoduodenectomy（PD）. Methods Eighty?two patients who underwent pancreaticoduodenectomy in our hospital from August 2013 to March 2017 were enrolled. Among them, 32 patients with postoperative refractory vomiting were used as observation group, and the other 50 without refractory vomiting served as a control group. ANOVA and Logistic regression were used to analyze the risk factors affecting the occurrence of refractory vomiting after PD operation. Then the specific nursing strategies were proposed and the nursing effect was analyzed by CIVIQ life scale. Results By univariate analysis, age（≥60 years）, preoperative total bilirubin（≥170 μmol/L）, preoperative albumin（≥35 g/L）preoperative fasting blood glucose（≥7.0 mmol/L）, intraoperative blood loss（≥250 mL）and postoperative complications were influenting factors of refractory vomiting after pancreaticoduodenectomy（all P values<0.05）. Risk factors affecting refractory vomiting after pancreaticoduodenectomy included preoperative albumin, preoperative fasting blood glucose, and postoperative complications（all P values<0.05）. The CIVIQ scores of the patients with refractory vomiting after pancreaticoduodenectomy were 70.20±11.21 and 89.38±15.45, respectively（P<0.05）. Conclusion The risk factors for refractory vomiting after pancreaticoduodenectomy include preoperative albumin, preoperative fasting blood glucose, and postoperative complications. The patients should be given the necessary care interventions to improve the quality of life of patients and improve the prognosis of patients.

Key words: nursing care, cause, pancreaticoduodenectomy, refractory vomiting, CIVIQ