腹腔镜袖状胃切除术对肥胖合并阻塞性睡眠呼吸暂停低通气综合征影响的近期疗效  

Short-term postoperative outcomes of laparoscopic sleeve gastrectomy for obesity combined with obstructive sleepapnea-hypopnea syndrome

作　　者：刘岩 李梦竹 胡扬喜 董星 刘宝胤 孟化 Liu Yan;Li Mengzhu;Hu Yangxi;Dong Xing;Liu Baoyin;eng Hua(Department of Gastrointestinal Metabolic Surgery,Zhengzhou Central Hospital,Zhengzhou University,Zhengzhou 450000,China;Department of Obstetrics and Gynaecology,Zhengzhou Central Hospital,Zhengzhou University,Zhengzhou 450000,China;Department of General Surgery&Obesity and Metabolic Disease Center,China-Japan Friendship Hospital,Beijing 100029,China)

机构地区：[1]郑州大学附属郑州中心医院胃肠代谢外科,郑州450000 [2]郑州大学附属郑州中心医院妇产科,郑州450000 [3]中日友好医院普外科代谢减重中心,北京100029

出　　处：《中华普通外科杂志》2024年第4期272-276,共5页Chinese Journal of General Surgery

摘　　要：目的探讨袖状胃切除术对肥胖合并阻塞性睡眠呼吸暂停低通气综合征影响的术后近期疗效,并分析其影响因素。方法回顾性分析2020年8月至2022年8月期间郑州大学附属郑州中心医院胃肠代谢外科收治的41例肥胖合并阻塞性睡眠呼吸暂停低通气综合征接受袖状胃切除术患者的临床资料,观察手术前后体测指标变化及睡眠改善情况,分析其相关性并通过多元线性回归筛选出影响因素。结果患者在术后12个月时体重、BMI、颈围、胸围、腰围、臀围均下降[35.4(24.9,43.8)kg、12.7(8.5,15.6)kg/m^(2)、(7.1±2.7)cm、19.5(15.0,24.5)cm、28.0(18.0,33.8)cm、23.0(18.3,28.8)cm],与术前比较差异均有统计学意义(t=15.242,P<0.001;Z=-5.579,P<0.001;Z=-5.585,P<0.001;t=14.612,P<0.001;t=15.729,P<0.001;t=16.781,P<0.001)。呼吸暂停低通气指数较术前下降[22.7(7.6,40.8)次/h],差异有统计学意义(Z=-5.579,P<0.001)。相关性分析显示体测指标与其呈显著正相关(0.5<r<0.8,P<0.05)。多元线性回归发现颈围、腰围对呼吸暂停低通气指数有正向预测作用(β=1.372,P<0.05;β=0.567,P<0.05)。术后总体重下降百分比为30.1%±7.7%,阻塞性睡眠呼吸暂停低通气综合征有效缓解率达到95%。结论袖状胃切除术不仅具有良好的减重效果,同时可有效缓解肥胖合并阻塞性睡眠呼吸暂停低通气综合征患者的病情。Objectives To investigate short-term postoperative outcome of laparoscopic sleeve gastrectomy(LSG)for obesity combined with obstructive sleep apnea-hypopnea syndrome(OSAHS).Methodss Clinical data of 41 cases of obesity combined with OSAHS undergoing LSG between Aug 2020 and Aug 2022 at the Department of Gastrointestinal Metabolic Surgery,Zhengzhou Central Hospital,Zhengzhou University were collected to observe the changes in body measurement indexes,and improvement in OSAHs before and after surgery,and analyze the correlation between the anthropometric indices and the apnoea-hypopnoea index(AHI),and determine factors influencing the AHI by multivariate linear regression.ResultsAfterpostoperative 12 mosths,body weight,body mass index,neck,chest,waist and hip measurements decreased by[35.4(24.9,43.8)kg、12.7(8.5,15.6)kg/m^(2)、(7.1±2.7)cm、19.5(15.0,24.5)cm、28.0(18.0,33.8)cm、23.0(18.3,28.8)cm].The differences were all statistically significant when compared with those before surgery(t=15.242,P<0.001;Z=-5.579,P<0.001;Z=-5.585,P<0.001;t=14.612,P<0.001;t=15.729,P<0.001;t=16.781,P<0.001).AHI decreased[22.7(7.6,40.8)events/h](Z=-5.579,P<0.001),and showing a significant positive correlation with body measurements(0.5<r<0.8,P<0.05);Multiple linear regression showed that neck and waist circumference positively predicted AHI(β=1.372,P<0.05;β=0.567,P<0.05).Postoperative percentage total weight loss(%TWL)was 30.1%±7.7%and effective OSAHS remission rate was 95%.Conclusion LSG not only has good weight loss effect,but also can effectively alleviate the condition of obese OSAHS patients.

关 键 词：肥胖症 病态 阻塞性睡眠呼吸暂停 胃切除术 腹腔镜 

分 类 号：R656.61[医药卫生—外科学] R766[医药卫生—临床医学]