OSA可能是引发麻醉意外的一种尚未被认识的原因  

OSA May Be an Unrecognized Cause of Anesthesia Accident

作　　者：何权瀛[1] HE Quanying(Department of Respiration,People's Hospital,Peking University,Beijing 100044,China)

机构地区：[1]北京大学人民医院呼吸科,北京100044

出　　处：《中国医药导刊》2024年第4期319-322,共4页Chinese Journal of Medicinal Guide

摘　　要：临床上对于麻醉意外的认识以往并未包括睡眠呼吸暂停问题。特别是全麻患者发生术中和术后合并症时,一般认为所涉及的原因大多是麻醉期间发生的反流、误吸、缺氧、吸氧、呼吸抑制、急性呼吸衰竭、术后苏醒延迟,很少涉及阻塞性睡眠呼吸暂停(OSA)问题。近年来,随着人们对于睡眠呼吸暂停危害认识的逐渐深入和扩展,发现外科麻醉时产生的问题可能与OSA有关。本研究在长期临床实践经验的基础上,推测OSA可能是造成麻醉意外(主要是全麻)的一种尚未被认识和重视的原因。本研究按照顺序逐层剖析和阐述其推测过程,在梳理导致OSA高危因素和发病条件的基础上,重点阐述OSA与麻醉意外之间的关系,分析OSA引发麻醉意外的原因,强调应充分认识OSA引发麻醉意外的危害,指出OSA患者术前若未进行必要的筛查诊断和干预处理,可能会出现系列不良后果;麻醉医生应时刻加强OSA患者围手术期的管理。Sleep apnea has not been included in the clinical understanding of anesthesia accident.Especially when complications occur during and after general anesthesia,it is believed that the most common causes are reflux,aspiration,hypoxia,oxygen inhalation,respiratory depression,acute respiratory failure,and delayed postoperative recovery,and obstructive sleep apnea(OSA)is rarely dis-cussed.In recent years,with awareness of the harm of OSA,it was found that the problems arising during surgical anesthesia may be related to OSA.Based on long-term clinical experience,this study speculated that OSA may be an unrecognized and neglected cause of anesthesia accidents(mainly general anesthesia).On the basis of sorting out the high risk factors and morbidity conditions leading to OSA,this study analyzed and expounded the process of speculation in sequence,and focused on the relationship between OSA and anes-thesia accidents,to analyze the causes of anesthesia accidents caused by OSA,and emphasized the importance of fully understanding the harm of anesthesia accidents caused by OSA.It is pointed out that a series of adverse consequences may occur in OSA patients without necessary screening diagnosis and intervention before operation and anesthesiologists should strengthen the perioperative management of OSA patients.

关 键 词：麻醉意外 阻塞性睡眠呼吸暂停 围手术期管理 

分 类 号：R563[医药卫生—呼吸系统]