CAJ | 학술논문

目的：比较阻塞性睡眠呼吸暂停综合征（ OSAS）患者行咽腭成形术后的围术期和远期氧合状况；评估STOP-BANG量表和mESS量表预测OSAS患者的敏感度和特异度。方法选取中日友好医院2009至2010年行咽腭成型术患者46例，对患者进行术后第1～3天氧饱和度的监测；对患者术后进行3年随访，复查睡眠多导图，测试STOP-BANG量表和mESS量表。结果咽腭成形术患者术后拔管1～4 h、第1天、第2天的血氧饱和度分别为96.6（92.0，99.0）％、94.9（90.7，98.4）％、95.3（90.2，97.7）％，高于术前的91.1（79.3，96.1）％，差异有统计学意义（ Z＝1.000，P＜0.01）；但术后第1天的血氧饱和度却低于拔管后1～4 h，差异有统计学意义（Z＝-3.6014，P＜0.01）。 OSAS患者行咽腭成型术后3年，睡眠时血氧饱和度为（88.84±6.16）％，与术前的（89.72±4.88）％相比，差异无统计学意义（ t＝1.029，P＞0.05）。 mESS量表可对患者的生活质量进行评估和了解，STOP-BANG量表对预测OSAS患者敏感度为80％，特异度为100％，可作为快速筛查OSAS患者的一个有效工具。结论咽腭成型术显著改善了OSAS患者的术后氧饱和度，但在术后24 h内仍存在缺氧事件，特别是术后第一晚。咽腭成型术并未改善患者长期的缺氧状况。
목적：비교조새성수면호흡잠정종합정（ OSAS）환자행인악성형술후적위술기화원기양합상황；평고STOP-BANG량표화mESS량표예측OSAS환자적민감도화특이도。방법선취중일우호의원2009지2010년행인악성형술환자46례，대환자진행술후제1～3천양포화도적감측；대환자술후진행3년수방，복사수면다도도，측시STOP-BANG량표화mESS량표。결과인악성형술환자술후발관1～4 h、제1천、제2천적혈양포화도분별위96.6（92.0，99.0）％、94.9（90.7，98.4）％、95.3（90.2，97.7）％，고우술전적91.1（79.3，96.1）％，차이유통계학의의（ Z＝1.000，P＜0.01）；단술후제1천적혈양포화도각저우발관후1～4 h，차이유통계학의의（Z＝-3.6014，P＜0.01）。 OSAS환자행인악성형술후3년，수면시혈양포화도위（88.84±6.16）％，여술전적（89.72±4.88）％상비，차이무통계학의의（ t＝1.029，P＞0.05）。 mESS량표가대환자적생활질량진행평고화료해，STOP-BANG량표대예측OSAS환자민감도위80％，특이도위100％，가작위쾌속사사OSAS환자적일개유효공구。결론인악성형술현저개선료OSAS환자적술후양포화도，단재술후24 h내잉존재결양사건，특별시술후제일만。인악성형술병미개선환자장기적결양상황。
Objective To explore the perioperative and long-term oxygenation status after uvulopalatopharyngealplasty ( UPPP ) in patients with obstructive sleep apnea syndrome ( OSAS ) and evaluate the predictive performance of STOP-BANG questionnaire and modified Epworth sleepiness scale ( mESS) scales.Methods Oxygen saturation was continuously monitored with pulse oximeter wristwatch for up to 72 h postoperatively in 46 patients undergoing UPPP.They were followed up after 3 years with polysomnography , STOP-BANG questionnaire and mESS scales.Results Oxygen saturation significantly improved postoperatively.The mean SPO2 was 96.6% during 1 to 4 hour after extubation , 94.9% on POD1, 95.3% on POD2 and 91.1% on pre-operation respectively.The differences were statistically significant (Z=1.000, P<0.01).However, there were still episodes of hypoxemia , especially during 1st postoperative night(Z=-3.601 4, P<0.01).There was no difference(t =1.029, P>0.05) in mean SPO2 between pre-operation (89.72 ±4.88)% and 3 years (88.84 ±6.16)% after UPPP.Conclusions Although UPPP significantly improves oxygen saturation in OSA patients , hypoxemic episodes still occur in the first 24 hours after surgery , especially during the first postoperative night.UPPP does not improve long-term hypoxemia.