阻塞性睡眠呼吸暂停低通气综合征的围手术期治疗  

Peri-operative treatment for obstructive sleep apnea hypopnea syndrome

作　　者：李延忠[1] 王岩[1] 

机构地区：[1]山东大学齐鲁医院耳鼻咽喉-头颈外科卫生部耳鼻喉科学重点实验室,济南250012

出　　处：《山东大学耳鼻喉眼学报》2008年第2期97-101,共5页Journal of Otolaryngology and Ophthalmology of Shandong University

基　　金：山东省科技攻关计划项目(编号:031050112)

摘　　要：目的探讨阻塞性睡眠呼吸暂停低通气综合征(OSAHS)围手术期的治疗措施和必要性。方法回顾性分析1 030例OSAHS患者围手术期发生各种严重并发症的情况。1 030例分为A组:2002年8月底以前未进行系统的围手术期治疗者396例;B组:2002年9月以后进行系统的围手术期治疗者634例,主要治疗包括手术前持续正压通气、术中熟练的技术操作并严格止血、术后监护等。结果A组术中因并发症死亡1例,术后发生原发性咽部出血10例、继发性出血15例、短期鼻咽返流35例、鼻咽闭锁1例。B组术后发生原发性咽部出血4例、继发性出血9例、短期鼻咽返流11例。与A组比较,B组并发症的发生率明显降低(P<0.05)。两组均无其他严重心脑血管并发症出现。结论OSAHS患者手术有极大的潜在危险,加强围手术期的治疗能显著提高患者对手术及麻醉的耐受性,降低手术风险,减少并发症的发生。Objective To investigate the management and implications during the peri-operative period of obstructive sleep apnea hypopnea syndrome（OSAHS）. Methods Serious complications during 1 030 OSAHS operations from 1998 to 2007 were retrospectively analyzed.Of them, before September 2002,396 patients（group A） were not treated with comprehensive management,and after September 2002,634 patients（group B） were treated with comprehensive managements.Results In group A,one patient died of complications,ten had primary hemorrhage,fifteen had secondary hemorrhage,thirty-five had nasopharyngeal refluxing in the short term,and one had nasopharyngeal clausura after the operations.In group B,four had primary hemorrhage,nine had secondary hemorrhage,eleven had nasopharyngeal refluxing in the short term after the operations.Complications were decreased in group B compared with group A（P〈0.05）.Conclusion Comprehensive pre-operative management can improve the patients; tolerance of surgery and anesthesia,and reduce surgical risks and post-operative complications.

关 键 词：睡眠呼吸暂停 阻塞性 围手术期 治疗 

分 类 号：R776.7[医药卫生—眼科]