CAJ | 학술논문

目的：观察术中吸入不同浓度氧对病态肥胖患者术后早期动脉血氧分压的影响。方法选择40例ASAⅢ级、因阻塞性睡眠呼吸暂停综合征（OSAS）拟择期行悬雍垂腭咽成形术的病态肥胖（BMI≥40 kg/m2）患者，采用随机数字表法分成80%氧浓度吸入组（H组）和60%氧浓度吸入组（L组），各20例，测定术前（T0）、气管拔管后10min（T1）、0.5h（T2）、2h（T3）的动脉血气分析指标并作比较。结果两组患者T0时动脉血气分析中的SaO2、PaO2、PaCO2、pH值的差异均无统计学意义（均P＞0.05），在T1、T2、T3各时点L组的SaO2、PaO2值明显高于H组（P＜0.05或0.01），在T1时点，L组的PaCO2明显低于H组（P＜0.05）。结论相较于80%的吸入氧浓度，病态肥胖的OSAS患者术中吸入60%浓度的氧，术后的氧合更好，有利于术后早期呼吸功能的恢复。
목적：관찰술중흡입불동농도양대병태비반환자술후조기동맥혈양분압적영향。방법선택40례ASAⅢ급、인조새성수면호흡잠정종합정（OSAS）의택기행현옹수악인성형술적병태비반（BMI≥40 kg/m2）환자，채용수궤수자표법분성80%양농도흡입조（H조）화60%양농도흡입조（L조），각20례，측정술전（T0）、기관발관후10min（T1）、0.5h（T2）、2h（T3）적동맥혈기분석지표병작비교。결과량조환자T0시동맥혈기분석중적SaO2、PaO2、PaCO2、pH치적차이균무통계학의의（균P＞0.05），재T1、T2、T3각시점L조적SaO2、PaO2치명현고우H조（P＜0.05혹0.01），재T1시점，L조적PaCO2명현저우H조（P＜0.05）。결론상교우80%적흡입양농도，병태비반적OSAS환자술중흡입60%농도적양，술후적양합경호，유리우술후조기호흡공능적회복。
Objective To investigate the effects of inspiring different concentrations of oxygen during surgery on blood oxygenation in morbidly obese patients after uvulopalatopharyngoplasty (UPPP) operation. Methods Forty morbidly obese pa-tients with obstructive sleep apnea syndrome (OSAS) scheduled for UPPP were randomly al ocated to receive either 60% (L group)or 80%(H group) oxygen during general anesthesia. Perioperative management was standardized, blood gas analysis were monitored preoperatively (T0) and at 10min (T1), 0.5h (T2), 2h (T3) after extubation. Extubation time was recorded. Results There was no statistical difference between two groups in SaO2, PaO2, PaCO2, PH value in arterial blood gas analysis at T0 point (P>0.05);SaO2, PaO2 values of L group was significantly higher than those of H group(P<0.05) at T1, T2 and T3 respectively;Pa-CO2 value of L group was significantly lower than that of H group at T1 (P<0.05). Conclusion Compared to 80%oxygen, inspir-ing 60%oxygen provides better oxygenation after surgery and promote early postoperative pulmonary function recovery for mor-bid obesity OSAS patients undergoing uvulopalatopharyngoplasty.