围手术期阻塞性睡眠呼吸暂停综合征患者的识别及其管理

Perioperative identification and management of patients with obstructive sleep apnea syndrome

阻塞性睡眠呼吸暂停综合征（obstructive sleep apnea syndrome, OSAS）是一种常见的与睡眠相关的呼吸功能紊乱，发病率约2％～25％，在择期手术人群中OSAS的患病率更高。一方面，镇静剂和麻醉药会增加上呼吸道的塌陷性，增加了这部分患者发生术后并发症的风险；另一方面，大部分OSAS患者没有被确诊也增加了手术期间的危险。因此，这部分OSAS患者的识别和诊断，对能否在手术期间给予及时合理的处理有重要作用。本文将如何在手术前识别OSAS患者及其围手术期的管理进行综述。

Obstructive sleep apnea syndrome （OSAS） is a common sleep related breathing disorder. Its prevalence is estimated to be between 2% and 25% in the general population. However, the prevalence of sleep apnea is much higher in patients undergoing selective surgery. Sedation and anesthesia have been shown to increase the upper airway collapsibility and therefore increasing the risk of having postoperative complications in these patients. Furthermore, the majority of patients with sleep apnea are undiagnosed and therefore are at risk during the perioperative period. It is important to identify these patients so that appropriate actions can be taken in a timely fashion. In this review article, we will review how to identify these patients preoperatively and the steps that can be taken for their perioperative management.