术中不同浓度氧对病态肥胖阻塞性睡眠呼吸暂停综合征患者术后早期动脉血氧分压的影响  

Effects of inspiring oxygen concentration during surgery on PaO_2 in morbidly obese patients with obstructive sleep apnea syndrome in early postoperative period

作　　者：徐琼[1,2] 陈普善[2] 胡双飞[2] 方向明[1] 

机构地区：[1]浙江大学医学院附属第一医院麻醉科,杭州310003 [2]浙江省人民医院麻醉科

出　　处：《浙江医学》2013年第19期1752-1754,共3页Zhejiang Medical Journal

摘　　要：目的观察术中吸入不同浓度氧对病态肥胖患者术后早期动脉血氧分压的影响。方法选择40例ASAⅢ级、因阻塞性睡眠呼吸暂停综合征(OSAS)拟择期行悬雍垂腭咽成形术的病态肥胖(BMI≥40 kg/m^2)患者,采用随机数字表法分成80%氧浓度吸入组(H组)和60%氧浓度吸入组(L组),各20例,测定术前(T_0)、气管拔管后10min(T_1)、0.5h(T_2)、2h(T_3)的动脉血气分析指标并作比较。结果两组患者T_0时动脉血气分析中的SaO_2、PaO_2、PaCO_2、pH值的差异均无统计学意义(均P>0.05),在T_2、T_2、T_3各时点L组的SaO__2、PaO_2值明显高于H组(P<0.05或0.01),在T_1时点,L组的PaCO__2明显低于H组(P<0.05)。结论相较于80%的吸入氧浓度,病态肥胖的OSAS患者术中吸入60%浓度的氧,术后的氧合更好,有利于术后早期呼吸功能的恢复。Objective To investigate the effects of inspiring different concentrations of oxygen during surgery on blood oxygenation in morbidly obese patients after uvulopalatopharyngoplasty （UPPP） operation. Methods Forty morbidly obese pa- tients with obstructive sleep apnea syndrome （OSAS） scheduled for UPPP were randomly allocated to receive either 60% （L group）or 80%（H group） oxygen during general anesthesia. Perioperative management was standardized, blood gas analysis were monitored preoperatively （To） and at 10rain （T1）, 0.5h （T2）, 2h （T3） after extubation. Extubation time was recorded. Results There was no statistical difference between two groups in SaO2, PaO2, PaCO2, PH value in arterial blood gas analysis at To point （P 〉0.05）; SaO2, PaO2 values of L group was significantly higher than those of H group（P〈0.05） at T1, T2 and T3 respectively; Pa- CO2 value of L group was significantly lower than that of H group at T1 （P〈0.05）. Conclusion Compared to 80% oxygen, inspir- ing 60% oxygen provides better oxygenation after surgery and promote early postoperative pulmonary function recovery for mor- bid obesity OSAS patients undergoing uvulopalatopharyngoplasty.

关 键 词：氧浓度 病态肥胖 阻塞性睡眠呼吸暂停综合征 血气分析 

分 类 号：R614[医药卫生—麻醉学]