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《阻塞性睡眠呼吸暂停低通气综合征患者围手术期无创正压通气治疗的临床意义.doc》由会员上传分享，免费在线阅读，更多相关内容在工程资料-天天文库。
1、阻塞性睡眠呼吸暂停低通气综合征患者围于•术期尢创止压通气治疗的临床意义作者：涂春美，刘洪英，孙睿杰,蔡晓岚单位：山东大学齐鲁医院耳鼻咽喉■头颈外科，济南【摘要】目的研究无创止压通气(CPAP)治疗对阻塞性睡眠呼吸暂停低通气综合征(OSAHS)围手术期的影响，探讨其对减少手术并发症的临床意义。方法対3&例OSAHS患者行术前诊断性及CPAP治疗下的多道睡眠监测，分析CPAP治疗前后睡眠结构、呼吸、血氧饱和度及微觉醒等监测指标的变化。结果CPAP治疗后，齐项指标较治疗前明显好转，患者睡眠结构趋于正常，1期浅睡眠减少，3+4期深睡眠及REM期睡眠明显增加；微觉醒、呼吸事件和血氧饱
2、和度下降幅度明显减少；轻、中、重度OSAHS患者各项指标变化有一定差界。经CPAP治疗后张口呼吸减少，同时，通过术前咽腔局部药物雾化治疗，患者咽腔充血明显减轻，术中、术后出血量不多，无高血压危象等严重并发症出现。结论围手术期CPAP治疗可有效改善OSHAS患者的睡眠结构，并通过纠止呼吸紊乱和血氧饱和度下降，达到稳定血液动力学变化的目的，对提高手术和麻醉耐受性，降低围手术期风险具有重要的临床意义。【关键词】睡眠呼吸暂停，阻塞性；持续止压通气；外科；围手术期TUChunmeil,LIUHongying2,SUNRuijiel,CAIXiaolanl(1.Depiirtmento
3、fOtorhinolaryngology&HeadandNeckSurgery,QiluHospitalofShandongUniversity,Jinan250012,China;2.DepartmentofOtorhinolaryngology&HeadandNeckSurgery,SecondAffiliatedHospitalofShandongUniversityofTraditionalChineseMedicine,Jinan250001,China)Toexploretheeffectsofperioperativecontinuouspositiveair
4、waypressure(CPAP)treatmentforpatientswithobstructivesleepapneahypopneasyndronie(OSAHS).MethodsThirtysixOSAHSpatientsweresubjectedtopolysonionography(PSG)forpreoperativediagnosisandforevaluationoftheeffectoftheCPAPtreatment.TwonightsPSGresults,includingsleeparchitecture,breathingevents,oxyg
5、endesaturationandarousalwerecompared.ResultsWiththeCPAPtreatment,stage1sleepwasdecreased,whilestage3+4sleepandtheREMsleepweresignificantlyincreased,alsoarousals,respiratoryeventsandthedegreeofoxygendesaturationweresignificantlydecreased.Changesoftheseparametersamongmild,moderateandsevereOS
6、AHSpatientswerestatisticallydifferent.LocaledemaandhyperemiainthepharyngealcavityofOSAHSpatientswererelieved.Nocomplicationsofhypertensivecrisishappened.ConclusionPerioperativeCPAPtreatmentcouldeffectivelydecreasethebreathingeventsandoxygendesaturationdegreeandsteadyhemodynamics,soastomake
7、patientstoleratesurgeryandanaesthesiaandreducesurgicalcrisisintheperioperationtorOSAHS.Keywords:Sleepapnea,obstructive;Continuouspositiveairwaypressure;Surgery;Perioperation手术是治疗阻塞性睡眠呼吸伞片停低通气综合征(obstructivesleepapneahypopneasyndrome,OSAHS)的主要手段之一。睡眠中反复发生的呼吸材停、
