北京医学
北京醫學
북경의학
BEIJING MEDICAL JOURNAL
2010年
1期
38-40
,共3页
纪存良%张炳熙%郭玉良%李天佐
紀存良%張炳熙%郭玉良%李天佐
기존량%장병희%곽옥량%리천좌
阻塞性睡眠呼吸暂停%低通气%镇静%镇痛%麻醉恢复室
阻塞性睡眠呼吸暫停%低通氣%鎮靜%鎮痛%痳醉恢複室
조새성수면호흡잠정%저통기%진정%진통%마취회복실
Obstructive%sleep%apnea%Hypopnea%Sedation%Analgesia%Post-anesthesia%care%unit
目的 回顾分析阻塞性睡眠呼吸暂停低通气综合征(obstructive sleep apnea and hypopnea syndrome,OSAHS)患者麻醉恢复室(post-anesthesia care unit,PACU)处理的临床资料,提高围术期安全性,降低并发症.方法 分析我院东区PACU收治的96例OSAHS患者,对镇静镇痛方式、呼吸机治疗、监测手段进行总结.结果 患者年龄26～62岁,体重70～112kg,呼吸暂停,低通气指数(AHI)≥40,合并高血压37例、糖尿病12例,心电图检查示ST段或T波改变22例,左心室高电压17例,完全性右束支传导阻滞9例.所有患者术后均保留经鼻气管插管PACU过夜,1例患者拔管后再插管人ICU治疗,其余患者术后第2天晨拔管返回病房,均未发生术后知晓、气管切开、术后出血.结论 重症OSAHS患者术后给予合理镇静镇痛留置气管导管过夜是安全和快速恢复的理想方式.
目的 迴顧分析阻塞性睡眠呼吸暫停低通氣綜閤徵(obstructive sleep apnea and hypopnea syndrome,OSAHS)患者痳醉恢複室(post-anesthesia care unit,PACU)處理的臨床資料,提高圍術期安全性,降低併髮癥.方法 分析我院東區PACU收治的96例OSAHS患者,對鎮靜鎮痛方式、呼吸機治療、鑑測手段進行總結.結果 患者年齡26～62歲,體重70～112kg,呼吸暫停,低通氣指數(AHI)≥40,閤併高血壓37例、糖尿病12例,心電圖檢查示ST段或T波改變22例,左心室高電壓17例,完全性右束支傳導阻滯9例.所有患者術後均保留經鼻氣管插管PACU過夜,1例患者拔管後再插管人ICU治療,其餘患者術後第2天晨拔管返迴病房,均未髮生術後知曉、氣管切開、術後齣血.結論 重癥OSAHS患者術後給予閤理鎮靜鎮痛留置氣管導管過夜是安全和快速恢複的理想方式.
목적 회고분석조새성수면호흡잠정저통기종합정(obstructive sleep apnea and hypopnea syndrome,OSAHS)환자마취회복실(post-anesthesia care unit,PACU)처리적림상자료,제고위술기안전성,강저병발증.방법 분석아원동구PACU수치적96례OSAHS환자,대진정진통방식、호흡궤치료、감측수단진행총결.결과 환자년령26～62세,체중70～112kg,호흡잠정,저통기지수(AHI)≥40,합병고혈압37례、당뇨병12례,심전도검사시ST단혹T파개변22례,좌심실고전압17례,완전성우속지전도조체9례.소유환자술후균보류경비기관삽관PACU과야,1례환자발관후재삽관인ICU치료,기여환자술후제2천신발관반회병방,균미발생술후지효、기관절개、술후출혈.결론 중증OSAHS환자술후급여합리진정진통류치기관도관과야시안전화쾌속회복적이상방식.
Objective To analyze retrospectively clinical data of patients with obstructive sleep apnea and hypopnea syndrome (OSAHS) in post-anesthesia care unit (PACU) in order to increase the patients' perioperative safety and minimize complications. Methods 96 cases of OSAHS in PACU of Beijing Tongren Hospital from January 2008 to December 2008 were analyzed retrospectively.Mode of sedation-analgesia,treatment of respirator and monitoring measure were summarized. Results Patients aged from 26 to 62 with apnea-hypopnea index (AHI)≥40 were recruited. The body weights were recorded from 70 to 112 kg. There were 37 cases complicated with hypertension and 12 with diabetes mellitus.The ECG of 22 cases revealed ST segment abnormality or ST-T changes. In addition, there were 17 cases whose ECG showed left ventricular high voltage and 9 cases with complete right bundle branch block.All of them underwent uvulopalatopharyngoplasty (UPPP) surgery with tracheal tube remained for 12～24 h, they were extubated on the second day after operation except one who was reintubated and transferred to ICU.No awareness was observed during sedation and no tracheotomy or postoperative hemorrhage occurred. Conclusions Tracheal tube should be remained in patients with severe OSAHS undergoing UPPP surgery till the next day.It is an ideal way to recovery from the suitable mode of sedation-analgesia.
