阻塞性睡眠呼吸暂停低通气综合征手术麻醉困难气道的因素预测

Prediction of Difficult Airway during Anesthesia in Patients with Obstructive Sleep Apnea Hypopnea Syndrome

目的:预测阻塞性睡眠呼吸暂停低通气综合征(OSAHS)患者手术过程中麻醉困难气道的相关因素,为临床评估手术困难气道提供参考。方法:选取阻塞性睡眠呼吸暂停低通气综合征患者120例作为研究对象,记录并分析患者所有相关临床资料,对其进行统计学处理分析,筛选出和困难气道相关的危险因素。结果:120例患者中发生面罩通气困难的有67例(55.83%),体质量指数(BMI)、呼吸暂停低通气指数(AHI)、最低血氧饱和度(LSaO_(2))等与困难通气存在相关性,与未发生面罩通气困难患者比较,差异有统计学意义(P<0.05)。通过对不同面罩通气分级患者进行指标分析,其中Ⅰ级患者的血红蛋白(Hb)、AHI、LSaO_(2)指标分别为(152.4±3.5)g/L、(36.4±3.6)次/h、(80.4±3.4)%。Ⅱ级患者的Hb、AHI、LSaO_(2)指标分别为(153.3±2.7)g/L、(38.4±4.4)次/h、(75.6±3.8)%。Ⅲ级患者的Hb、AHI、LSaO_(2)指标分别为(154.4±2.5)g/L、(41.4±3.6)次/h、(70.4±3.3)%。结论:对于OSAHS患者应当密切监测BMI、AHI、LSaO_(2),可为手术中麻醉困难气道提供一定参考依据。

Objective:To predict patients with obstructive sleep apnea hypopnea syndrome(OSAHS)difficult airway anesthesia related factors in the process of operation,provide reference for clinical evaluation operation difficult airway.Methods:A total of 120 patients with obstructive sleep apnea hypopnea syndrome were selected as the research objects.All the relevant clinical data were recorded and analyzed.The statistical analysis was carried out to screen out the risk factors related to difficult airway.Results:Among 120 patients,67(55.83%)had difficulty in mask ventilation,body mass index(BMI),apnea hypoventilation index(AHI)and lowest oxygen saturation(LSaO_(2))were correlated with difficult ventilation.Compared with patients without mask dyspnea,the difference was statistically significant(P<0.05).Through the index analysis of patients with different mask ventilation grades,the indexes of hemoglobin(HB),AHI and LSaO_(2) were(152.4±3.5)g/L,(36.4±3.6)times/h and(80.4±3.4)%respectively in gradeⅠpatients.The indexes of Hb,AHI and LSaO_(2) in gradeⅡpatients were(153.3±2.7)g/L,(38.4±4.4)times/h and(75.6±3.8)%,respectively.The indexes of Hb,AHI and LSaO_(2) in gradeⅢpatients were(154.4±2.5)g/L,(41.4±3.6)times/h and(70.4±3.3)%,respectively.Conclusion:Patients with OSAHS should be closely monitored the BMI,AHI,LSaO_(2),which can provide certain reference basis for surgical anesthesia in difficult airway.