减重代谢手术治疗Ⅲ度肥胖合并重度OSAHS效果分析  

Therapeutic effect of metabolic and bariatric surgery for severe OSAHS in obese patients

作　　者：陈庆文 李鹏[2] 冯盈[2] 王东琴 王晓燕 沈倪美[5] 达鹏[3] 吴昊[3] CHEN Qingwen;LI Peng;FENG Ying;WANG Dongqin;WANG Xiaoyan;SHEN Nimei;DA Peng;WU Hao(Department of Otorhinolaryngology,Nantong Rich Hospital,Nantong 226010;Department of General Surgery,the Affiliated Hospital of Nantong University;Department of Otorhinolaryngology,the Affiliated Hospital of Nantong University;Department of Pneumology,the Affiliated Hospital of Nantong University;Department of Otorhinolar-yngology,Nantong First People′s Hospital,Jiangsu Province)

机构地区：[1]南通瑞慈医院耳鼻咽喉科,南通226010 [2]南通大学附属医院普外科 [3]南通大学附属医院耳鼻咽喉科 [4]南通大学附属医院呼吸内科 [5]江苏省南通市第一人民医院耳鼻咽喉科

出　　处：《南通大学学报（医学版）》2020年第1期33-35,共3页Journal of Nantong University(Medical sciences)

基　　金：南通市“重点病种的临床规范化诊疗”基金资助项目(MS32017004)。

摘　　要：目的:评估腹腔镜下袖状胃切除术对Ⅲ度肥胖合并重度阻塞性睡眠呼吸暂停低通气综合征(obstructive sleep apnea-hyponea syndrome,OSAHS)的治疗效果。方法:Ⅲ度肥胖患者18例经多导睡眠监测确诊为重度OSAHS,并排除上气道器质性狭窄者,采用腹腔镜下袖状胃切除术,比较术前及术后6个月体质量指数(body mass index,BMI)、睡眠暂停低通气指数(apnea hyponea index,AHI)、最低血氧饱和度(lowest oxygen saturation,LSaO2)、嗜睡量表评分(the epworth sleeping scale,ESS)。结果:所有患者安全度过围术期,无严重并发症发生。术后BMI指数下降明显,患者术后6个月AHI、LSaO2、ESS评分与术前相比差异均有统计学意义(均P<0.05)。结论:对于单纯Ⅲ度肥胖症合并OSAHS患者,采用微创减重代谢手术不仅减重明显,提高了患者的生活质量,而且明显改善了睡眠呼吸暂停低通气状况,实现了OSAHS治疗的多学科联合、规范化及个性化的理念。Objective:To evaluate the effect of laparoscopic sleeve gastrectomy for severe obstructive sleep apnea-hyponea syndrome(OSAHS)in obese patients.Methods:Eighteen patients with gradeⅢobesity and excluded with upper airway organic stenosis were diagnosed as severe OSAHS by polosomnography(PSG)accepted laparoscopic sleeve gastrectomy.PSG was performed before and 6 months after surgery.Body mass index(BMI),apnea hyponea index(AHI),lowest oxygen saturation(LSaO2),and the epworth sleeping scale(ESS)scores were compared.Results:No serious complications occured during the perioperative period.The postoperative BMI index was decreased significantly.The AHI index,LSaO2,and ESS scores were both better than that before treatment,the differences were statistically significant(P<0.01).Conclusion:For gradeⅢobese patient associated with OSAHS,minimally invasive weight loss metabolic surgery not only reduces weight,but also significantly improves the status of sleep and the quality of patients′lives.It is multidisciplinary integration,standardization and personalization in OSAHS treatment.

关 键 词：阻塞性睡眠呼吸暂停综合征 减重代谢外科 肥胖 多导睡眠监测 

分 类 号：R563.8[医药卫生—呼吸系统]