【摘要】 目的 探讨阿片类药物致恶心呕吐的临床特点及预防治疗策略，旨在为其临床合理应用提供参考。方法 检索中国知网、维普网、万方数据、PubMed以及Web of Science数据库，收集阿片类药物致恶心呕吐的病例报告，提取相关信息，包括患者性别、年龄、原患疾病、阿片类药物用药原因、用法用量、联合用药、恶心呕吐发生时间、临床处理及转归等，并对获得的数据进行描述性统计分析。结果 共纳入21篇病例报告，涉及21例患者，女性13例，男性8例，平均年龄45岁。患者用药原因包括术中麻醉6例、癌痛6例、慢性疼痛4例、自我治疗4例、无痛分娩1例。共涉及相关药物9种，包括卡痛、氢可酮、芬太尼、布比卡因、吗啡、可卡因、大麻、羟考酮和氢吗啡酮。出现恶心、呕吐症状后，21例患者中16例停药，4例减量使用；均使用药物对症治疗，13例恢复正常，7例症状改善，1例因急性心肌梗死死亡。结论 通过停药、药物减量及对症治疗可有效改善患者使用阿片类药物致恶心呕吐的症状，防治阿片类药物致恶心呕吐的策略应综合考虑药物选择、剂量调整、改变给药途径、联合用药、止吐药物和非药物干预措施，以实现最佳的疗效和患者舒适度。更多还原

【Abstract】 Objective To explore the clinical characteristics and prevention and treatment strategies of nausea and vomiting caused by opioid drugs, aiming to provide references for the rational clinical use of these drugs. Methods Case reports of nausea and vomiting caused by opioid drugs from CNKI, VIP, Wanfang, PubMed and Web of Science databases were retrieved, and relevant information including gender, age, underlying diseases, reasons for opioid drug use, dosage and administration, combined medication, time of occurrence of nausea and vomiting, clinical management and outcomes were extracted, and descriptive statistical analysis on the obtained data were conducted. Results A total of 21 case reports involving 21 patients were included, including 13 females and 8 males, with an average age of 45 years. The reasons for drug use included intraoperative anesthesia in 6 cases, cancer pain in 6 cases, chronic pain in 4 cases, self-treatment in 4 cases, and painless delivery in 1 case. Nine related drugs were involved, including ketamine, hydrocodone, fentanyl, bupivacaine, morphine, cocaine, cannabis, oxycodone and hydromorphone. After the occurrence of nausea and vomiting symptoms, 16 of the 21 patients stopped the medication, and 4 reduced the dosage. All patients received symptomatic treatment with drugs, and 13 recovered normally, 7 improved, and1 died of acute myocardial infarction. Conclusion By stopping the medication, reducing the dosage and providing symptomatic treatment, the symptoms of nausea and vomiting caused by opioid drugs can be effectively improved. The prevention and treatment strategies for opioid-induced nausea and vomiting should comprehensively consider drug selection, dose adjustment, changing the route of administration, combined medication, antiemetic drugs and non-pharmacological intervention measures to achieve the best therapeutic effect and patient comfort.更多还原