围术期气道正压通气治疗对OSAHS患者手术效果影响

Effect of Positive Airway Pressure Ventilation During Perioperative Period on the Outcomes of OSAHS Patients

目的探讨阻塞性睡眠呼吸暂停低通气综合征(OSAHS)患者围术期行气道正压通气治疗对手术效果的影响。方法选取我院行悬雍垂腭咽成形术(UPPP)的56例重度阻塞性睡眠呼吸暂停低通气综合征(OSAHS)患者,随机分为两组各28例。对照组给予围术期常规治疗护理,观察组在对照组基础上于患者围术期给予气道正压通气治疗。观察两组患者术程血氧饱和度(SaO2)、平均动脉压(MAP)和心率(HR)波动情况,以及术程及术后不良反应。结果观察组术程SaO2平均值均明显优于对照组;观察组手术结束前30min(T0)、手术结束时(T1)和气管拔管时(T2)3个时间点的MAP和HR波动幅度明显低于对照组;观察组术程及术后总体不良反应发生率明显低于对照组(P<0.05)。结论OSAHS患者围术期行气道正压通气治疗,可显著提高患者深度睡眠状态下血氧饱和度,提高患者对手术及麻醉耐受性,减少围术期不良反应,保证手术质量和安全。

Objective To investigate the effect of positive airway pressure ventilation on operative outcomes in patients with obstructive sleep apnea-hypopnea syndrome(OSAHS)with adult snoring.Methods We selected 56 patients with severe vasospasm of OSAHS in our hospital who underwent uvulopalatopharyngoplasty(UPPP)and were divided into control group and observation group in 28 cases according to random number method.The control group was given perioperative routine care,and the observation group was given positive airway pressure ventilation during the perioperative period on the basis of the control group.The pulse oxygen saturation(SaO2),mean arterial pressure(MAP),and heart rate(HR)fluctuations,as well as the course and adverse reactions after surgery,were compared between the two groups.Results SaO2 mean value of the observation group was significantly better than the control group;observation group before the end of surgery 30min(T0),the end of the surgery(T1)and tracheal extubation(T2)3 times The amplitudes of MAP and HR fluctuations were significantly lower in the control group than in the control group;the incidence of total adverse events in the observation group and the postoperative period was significantly lower than that in the control group;the difference was statistically significant(P<0.05).Conclusion Combined positive airway pressure ventilation with OSAHS adult delirium can significantly improve blood oxygen saturation in patients with deep sleep,improve patient's tolerance to surgery and anesthesia,reduce perioperative adverse reactions,and ensure the quality and safety of surgery.