摘要
目的研究无创正压通气(CPAP)治疗对阻塞性睡眠呼吸暂停低通气综合征(OSAHS)围手术期的影响,探讨其对减少手术并发症的临床意义。方法对36例OSAHS患者行术前诊断性及CPAP治疗下的多道睡眠监测,分析CPAP治疗前后睡眠结构、呼吸、血氧饱和度及微觉醒等监测指标的变化。结果CPAP治疗后,各项指标较治疗前明显好转,患者睡眠结构趋于正常,1期浅睡眠减少,3+4期深睡眠及REM期睡眠明显增加;微觉醒、呼吸事件和血氧饱和度下降幅度明显减少;轻、中、重度OSAHS患者各项指标变化有一定差异。经CPAP治疗后张口呼吸减少,同时,通过术前咽腔局部药物雾化治疗,患者咽腔充血明显减轻,术中、术后出血量不多,无高血压危象等严重并发症出现。结论围手术期CPAP治疗可有效改善OSHAS患者的睡眠结构,并通过纠正呼吸紊乱和血氧饱和度下降,达到稳定血液动力学变化的目的,对提高手术和麻醉耐受性,降低围手术期风险具有重要的临床意义。
Objective To explore the effects of perioperative continuous positive airway pressure （CPAP） treatment for patients with obstructive sleep apnea hypopnea syndrome（OSAHS）. Methods Thirty-six OSAHS patients were subjected to polysomonography（PSG） for pre-operative diagnosis and for evaluation of the effect of the CPAP treatment. Two nights PSG results, including sleep architecture, breathing events, oxygen desaturation and arousal were compared. Results With the CPAP treatment, stage 1 sleep was decreased, while stage 3 ＋ 4 sleep and the REM sleep were significantly increased, also arousals, respiratory events and the degree of oxygen de-saturation were significantly decreased. Changes of these parameters among mild, moderate and severe OSAHS patients were statistically different. Local edema and hyperemia in the pharyngeal cavity of OSAHS patients were relieved. No complications of hypertensive crisis happened. Conclusion Perioperative CPAP treatment could effectively decrease the breathing events and oxygen desaturation degree and steady hemodynamies, so as to make patients tolerate surgery and anaesthesia and reduce surgical crisis in the perioperation for OSAHS.
出处
《山东大学学报（医学版）》
CAS
北大核心
2008年第5期538-541,共4页
Journal of Shandong University:Health Sciences
关键词
睡眠呼吸暂停
阻塞性
持续正压通气
外科
围手术期
Sleep apnea, obstructive
Continuous positive airway pressure
Surgery
Perioperation
