若不进行积极评估，潜在的危及生命的睡眠呼吸暂停可能会被漏诊。
Potentially life-threatening sleep apnea is unrecognized without aggressive evaluation.
作者信息
Hallowell Peter T, Stellato Thomas A, Schuster Margaret, Graf Kristen, Robinson Ann, Crouse Cathleen, Jasper John J
机构信息
Department of Surgery Case Medical School and Bariatric Surgery Program, University Hospitals Case Medical Center, 11100 Euclid Ave., Cleveland, OH 44106, USA.
出版信息
Am J Surg. 2007 Mar;193(3):364-7; discussion 367. doi: 10.1016/j.amjsurg.2006.09.022.
BACKGROUND
Many patients undergoing bariatric surgery have severe comorbidities, including obstructive sleep apnea (OSA). We suspected that sleep apnea was underdiagnosed in our study population.
METHODS
A retrospective chart review of our bariatric database was conducted comparing OSA evaluation based on clinical parameters (Era 1) with mandatory OSA evaluation for all patients (Era 2).
RESULTS
In both Era groups approximately 19% of patients presented to our program with an established diagnosis of OSA. In Era 1 this increased to 56% based on clinical parameters and in Era 2 this increased to 91% with mandatory polysomnography testing of all patients.
CONCLUSIONS
OSA is grossly underdiagnosed in patients with morbid obesity presenting for bariatric surgery. Clinical evaluation continues to miss a substantial percentage of patients with OSA. Mandatory testing of all patients for OSA with polysomnography before bariatric surgery is recommended.
背景
许多接受减肥手术的患者患有严重的合并症，包括阻塞性睡眠呼吸暂停（OSA）。我们怀疑在我们的研究人群中睡眠呼吸暂停未得到充分诊断。
方法
对我们的减肥数据库进行回顾性病历审查，将基于临床参数的OSA评估（第1阶段）与所有患者的强制性OSA评估（第2阶段）进行比较。
结果
在两个阶段组中，约19%的患者在我们的项目中被确诊为OSA。在第1阶段，根据临床参数这一比例增至56%，在第2阶段，对所有患者进行强制性多导睡眠图测试后这一比例增至91%。
结论
在接受减肥手术的病态肥胖患者中，OSA严重未得到充分诊断。临床评估仍会遗漏相当比例的OSA患者。建议在减肥手术前对所有患者进行多导睡眠图的OSA强制性检测。
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