Pierre Robin综合征低龄患者行腭裂修复术围手术期的风险评价

Perioperative risk factors evaluation of cleft palate repair in Pierre Robin sequence at early age

目的 评价PierreRobin综合征低龄患者施行腭裂修复术围手术期的风险 ,并探讨控制风险的手段。方法 2 0 0 1年 5月～ 2 0 0 4年 2月北京大学口腔医学院收治PierreRobin综合征患者共6例 ,均由同一名颌面外科医师采用vonLangenbeck术式进行腭裂修复 ,围手术期行血氧监测 ,术前及术后第 4天行多导睡眠仪监测。结果 所有患者均在麻醉插管时出现不同程度的低氧血症 ,只有1例在术后 2h内出现了呼吸困难伴严重的低氧血症。睡眠监测结果显示 ,患者手术后睡眠呼吸紊乱的程度比术前并无明显加重。结论 低龄PierreRobin综合征患者实施腭裂修复术围手术期的风险主要是严重的低氧血症 ,经过全面的术前风险评价及严格的风险控制 。

Objective To evaluate the perioperative risk factors of the cleft palate repair in Pierre Robin sequence patients at early age and to investigate how to control the risk factors. Methods Six consecutive patients with Pierre Robin sequence underwent primary repair of cleft palate in Department of Oral Maxillofacial Surgery ,Peking University School of Stomatology from June 2001 to February 2004. The patients underwent von Longenbeck operation by the same perioperative observation of serum oxygen saturation were obtained for these patients. patients included 4 males and 2 females with age of 9 months to 5 surgeon. Pre and post operative polysomnographic studies and years. Results All the patients suffered various degree of hypoxaemia during the period of intubation. There was only one patient who had hypoxaemia within the first 2 hours during postanaesthetic recovery period .No obvious difference was found in apnea and hypopnea index (AHI) among the patients before and after operation. Conclusions Severe hypoxaemia may happen in perioperative period when the patients with PRS underwent cleft palate repair. Most patients with PRS could undergo cleft palate repair safely performed by experienced surgeon at early age under comprehensive consideration and careful control of the risk factors.