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接受结肠镜检查的患者:筛查睡眠呼吸暂停的绝佳机会。

Patients presenting for colonoscopy: A great opportunity to screen for sleep apnea.

作者信息

Harvin Glenn, Ali Eslam, Raina Amit, Leland William, Abid Sabeen, Vahora Zahid, Movahed Hossein, Kachru Sumyra, Tee Rick

机构信息

Glenn Harvin, Eslam Ali, Amit Raina, William Leland, Brody School of Medicine at East Carolina University, Greenville, NC 27834, United States.

出版信息

World J Gastrointest Endosc. 2016 Nov 16;8(19):697-700. doi: 10.4253/wjge.v8.i19.697.

Abstract

AIM

To discover the prevalence and the feasibility of screening for obstructive sleep apnea (OSA) in patients presenting for routine colonoscopy.

METHODS

Adult patients having a colonoscopy for routine indications at our outpatient endoscopy center were eligible if they did not carry a diagnosis of OSA or had not had a prior sleep study. All patients were administered the Berlin questionnaire prior to the procedure. Mallampati, neck circumference, height, weight, and BMI were obtained for each patient. Patients were observed for any drops in oxygen saturation < 92% or the presence of snoring for > 10 s. Patients were determined to be high-risk if they met at least 2 of the 3 symptom categories for the Berlin questionnaire.

RESULTS

A total of 60 patients were enrolled and completed the study; mean age was 56 years (range 23-72 year). Twenty-six patients had a positive Berlin questionnaire (43.3%), 31 patients had a negative Berlin questionnaire (51.6%) and 3 patients had an equivocal result (5.0%). Patients with a positive Berlin questionnaire were more likely to be of increased weight (mean 210.5 lbs mean 169.8 lbs, = 0.003), increased BMI (33.0 kg/m 26.8 kg/m, = 0.0016), and have an increased neck circumference (38.4 cm 35.5 cm, = 0.012). Patients with a positive Berlin questionnaire were more likely to have a drop in oxygen saturation < 92% (76.9% 36.4%, = 0.01). Patients with snoring were more likely to have a positive Berlin questionnaire (8/9 patients 1/31 patients with negative Berlin questionnaire; = 0.0045).

CONCLUSION

Risk for OSA is extremely common in a population presenting for a routine colonoscopy, and screening at the time of a colonoscopy offers an excellent opportunity to identify these patients.

摘要

目的

探讨在接受常规结肠镜检查的患者中阻塞性睡眠呼吸暂停(OSA)的患病率及筛查的可行性。

方法

在我们门诊内镜中心因常规指征接受结肠镜检查的成年患者,若未被诊断为OSA或此前未进行过睡眠研究,则符合纳入标准。所有患者在检查前均接受柏林问卷评估。记录每位患者的马兰帕蒂分级、颈围、身高、体重和体重指数。观察患者是否存在氧饱和度降至<92%或打鼾持续>10秒的情况。若患者符合柏林问卷3个症状类别中的至少2项,则判定为高危。

结果

共纳入60例患者并完成研究;平均年龄为56岁(范围23 - 72岁)。26例患者柏林问卷结果为阳性(43.3%),31例患者柏林问卷结果为阴性(51.6%),3例患者结果不明确(5.0%)。柏林问卷结果为阳性的患者体重更可能增加(平均210.5磅 平均169.8磅,P = 0.003),体重指数更高(33.0kg/m² 26.8kg/m²,P = 0.0016),颈围更大(38.4cm 35.5cm,P = 0.012)。柏林问卷结果为阳性的患者更可能出现氧饱和度降至<92%的情况(76.9% 36.4%,P = 0.01)。打鼾的患者更可能柏林问卷结果为阳性(柏林问卷阳性的8/9例患者 柏林问卷阴性的1/31例患者;P = 0.0045)。

结论

在接受常规结肠镜检查的人群中,OSA风险极为常见,结肠镜检查时进行筛查为识别这些患者提供了绝佳机会。

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