鼻咽通气道应用于OSAHS患者术后辅助通气的观察.docVIP

鼻咽通气道应用于OSAHS患者术后辅助通气的观察 　　摘要：目的 探讨鼻咽通气道（Nasopharyngeal airway，NPA）对于重度阻塞性睡眠呼吸暂停综合征（Bdstructive sleep apnea hypoapnea syndrome，OSAHS）患者悬雍垂腭咽成形术（Uvulopalatopharyngoplasty，UPPP）后辅助通气的效果及对血流动力学指标的影响。方法 经多导睡眠呼吸监测（Polysomnography，PSG）诊断为重度OSAHS于全身麻醉下行UPPP的患者40例，随机分成实验组和对照组各20例。比较两组患者术后复苏室（Postanesthesia care unit，PACU）停留时间内血氧饱和度（SPO2）、心率（HR）、平均动脉压（MAP）、气道干预治疗次数和二次气管插管率。结果 两组患者年龄、体重及性别方面无统计学差异。实验组患者各时段SPO2高于对照组（P0.05），气道干预治疗次数、二次气管插管率低于对照组（P0.05），HR、MAP波动小于对照组（P0.05）。结论 OSAHS患者UPPP术后放置NPA能够改善通气状况，降低上呼吸道梗阻发生率，防止患者术后缺氧，维持血流动力学稳定。 　　关键词：鼻咽通气道；全身麻醉；阻塞性睡眠呼吸暂停综合征；悬雍垂腭咽成形术 　　Abstract：Objective To investigate nasopharyngeal airway for patients with severe obstructive sleep apnea syndrome after uvulopalatopharyngoplasty assisted ventilation effects and its influences on hemodynamics. Methods A total of 40 patients diagnosed as OSAHS， scheduled for UPPP under general anesthesia， were randomly assigned to experimental group（n=20）and control group（n=20）. The pulse oxygen saturation （SpO2）， heart rate （HR）， mean artery pressure （MAP）， and numbers of airway intervention and measures and the rate of second tracheal intubation were recorded in PACU. Results The two groups were similar with respect to age， weight and gender. In each point， SpO2 of experimental group was higher than the control group （P0.05）， while numbers of airway intervention and the rate of second tracheal intubation in experimental group were less than the control group （P0.05）. Compare with the control group， the fluctuations of heart rates and MAP were smaller in experimental group （P0.05）. Conclusion Nasopharyngeal airway can improve ventilation， reduce the incidence of upper respiratory obstruction， prevent postoperative hypoxemia， and ensure hemodynamic stability in OSAHS patients after UPPP. 　　Key words：Nasopharyngeal airway； General anesthesia； Obstructive sleep apnea hypopnea syndrome； Uvulopalatopharyngoplasty 　　重度阻塞性睡眠呼吸暂停综合征（OSAHS）患者睡眠时反复呼吸暂停低通气，导致血氧饱和度下降、睡眠结构紊乱，可造成诸多危害，严重影响患者的生活质量和寿命。UPPP手术治疗是治疗OS