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[阻塞性睡眠呼吸暂停综合征中鼻咽和口咽气道及围手术期多平面手术应用]

[Nasopharyngeal and oropharyngeal airway in obstructive sleep apnea syndrome, multi-plane operation application of perioperative].

作者信息

Wang Jie, Jiang Zhenhua, Dong Chuan, Liu Qingjun, Deng Wei, Liu Guoqi, Chen Liling, Zhang Zhen

机构信息

Department of Otolaryngology Head and Neck Surgery, Mianyang Central Hospital, Mianyang, 621000, China.

出版信息

Lin Chuang Er Bi Yan Hou Tou Jing Wai Ke Za Zhi. 2011 Sep;25(18):830-3.

Abstract

OBJECTIVE

To compare the mitigation role of nasopharyngeal and oropharyngeal airway in obstructive sleep apnea hypopnea syndrome (OSAHS) patients with upper airway obstruction after multiple plane operation. Observed parameters included life quality, the clinical value and reliability of nasopharyngeal and oropharyngeal airway.

METHOD

The nasopharyngeal airway group, 56 patients with PSG in patients diagnosed with severe OSAHS, after setting nasopharyngeal airway. Oropharyngeal airway group, 45 cases of OSAHS by PSG confirmed severe patients home after oropharyngeal airway, the same as the other treatment groups. Line postoperative ECG, oxygen saturation and hemodynamic monitoring. Two groups were compared in 24 h breathing difficulties, low oxygen saturation, hemodynamics, pharyngeal pain and discomfort of the situation.

RESULT

The multiplane after 24 h, the nasopharyngeal airway in patients hemodynamics HR (82.3 +/- 2.65) times/min, SBP(124.5 +/- 13.95) mmHg, DBP (76.2 +/- 8.1) mmHg, RPP(10282.0 +/- 1481.7), port pharyngeal airway in patients hemodynamics HR (93.4 +/- 2.89)times/min, SBP (135.1 +/- 16.5) mmHg, DBP (92.25 +/- 11.25) mmHg. There was significant difference between the two group (P < 0.05); pharyngeal pain nasopharyngeal airway group (1.71 +/- 0.45) points, oropharyngeal airway group (310) points, there was significant difference between the two (P < 0.05); nasopharyngeal airway breathing difficulties Group 0, 0 oropharyngeal airway group, no significant difference between the two (P > 0.05); the lowest oxygen saturation nasopharyngeal airway group (95.2 +/- 1.6)%, oropharyngeal airway group (95.41 +/- 1.34)%, no significant difference between the two (P > 0.05). 24 h before and after surgery between patients with the same group in the hemodynamic parameters (HR,SBP,DBP,RPP), pharyngeal pain, lowest oxygen saturation difference was statistically significant areas (P < 0.05).

CONCLUSION

Ventilation tube in the nasopharynx and oropharynx in patients with severe OSAHS the same period of postoperative respiratory management plane could well lift the upper airway obstruction. However, nasopharyngeal ventilation tube has a better hemodynamic stability and tolerance, it can reduce patient suffering and increased health and safety from, it is a more safe, minimally invasive and effective method.

摘要

目的

比较鼻咽通气道和口咽通气道对多平面手术后上气道梗阻的阻塞性睡眠呼吸暂停低通气综合征(OSAHS)患者的缓解作用。观察指标包括生活质量、鼻咽通气道和口咽通气道的临床价值及可靠性。

方法

鼻咽通气道组,56例经多导睡眠图(PSG)确诊为重度OSAHS的患者,置入鼻咽通气道后观察。口咽通气道组,45例经PSG确诊为重度OSAHS的患者回家后使用口咽通气道,其他治疗同前组。行术后心电图、血氧饱和度及血流动力学监测。比较两组24小时内呼吸困难、低氧饱和度、血流动力学、咽痛及不适情况。

结果

多平面手术后24小时,鼻咽通气道组患者血流动力学指标心率(HR)(82.3±2.65)次/分,收缩压(SBP)(124.5±13.95)mmHg,舒张压(DBP)(76.2±8.1)mmHg,心率收缩压乘积(RPP)(10282.0±1481.7);口咽通气道组患者血流动力学指标HR(93.4±2.89)次/分,SBP(135.1±16.5)mmHg,DBP(92.25±11.25)mmHg。两组比较差异有统计学意义(P<0.05);鼻咽通气道组咽痛评分为(1.71±0.45)分,口咽通气道组为(3.10)分,两组差异有统计学意义(P<0.05);鼻咽通气道组呼吸困难0例,口咽通气道组0例,两组差异无统计学意义(P>0.

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