悬雍垂腭咽成形术中控制性降压的应用研究

Clinical research of induced hypotensive used in uvulopalaatopharyngoplasty (UPPP)

目的 探讨控制性降压应用于悬雍垂腭咽成形术(UPPP)中的意义 .方法 10 0例阻塞性睡眠呼吸暂停综合征(OSAS)患者随机分为两组 ,对照组采用静吸复合全麻 ,降压组 (IH)采用控制性降压全麻 .结果 血液稀释下 ,IH组术中平均动脉压 (MAP)、心率 (HR)均较对照组明显降低 (P<0 .0 5 or P<0 .0 1) ,而对照组术中 MAP,HR维持在高水平 ,且波动幅度较大 ;IH组术野出血量较对照组显著减少 (P<0 .0 1) ,手术时间明显缩短 (P<0 .0 5 ) ;IH组术野清晰度提高 ,方便术者操作 ,减轻手术创伤 .结论 初步认为 :控制性降压应用于 UPPP手术中安全。

AIM To appreciate the meaning of induced hypotension (IH) being used undergoing uvulopalato pharyngoplasty (UPPP). METHODS One hundred patients of obstructive sleep apnea syndrome (OSAS) were randomly divided into two groups (Control & IH). Introvenous inhalational complexed anesthesia was used in Control and induced hypotensive general anesthesia was used in IH. RESULTS Under the condition of haemodilution, the introperative mean arterial pressure (MAP) and heart rate (HR) in IH were significantly lower than those in control ( P < 0.05 or P <0.01). However, the introperative MAP and HR in control were maintained at high level, whcih fluctuated greatly. Blood loss in operative scope in IH was significantly reduced and much less than those in Control ( P <0.01). Operation time in IH was shortened considerably ( P <0.05). Operative view clarity in IH was much better than those in Control, which made it convenient for surgeons to perform operation and reduce operative trauma. CONCLUSION Our study preliminarily shows that induced hypotension is safe and effective to be used in UPPP.