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OSA 手术前后血压变化。

Alternations of Blood Pressure Before and After OSA Surgery.

机构信息

Department of Otolaryngology, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Kaohsiung.

Department of Ophthalmology, Division of Glaucoma, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Kaohsiung.

出版信息

Otolaryngol Head Neck Surg. 2020 Oct;163(4):843-848. doi: 10.1177/0194599820926137. Epub 2020 Jun 2.

Abstract

OBJECTIVE

To investigate the changes of blood pressure (BP) on patients with obstructive sleep apnea/hypopnea syndrome (OSA) before and after upper airway surgery.

DESIGN

Case series with chart review.

SETTING

Tertiary academic medical center.

SUBJECTS AND METHODS

Patients with OSA who underwent upper airway surgery were enrolled. We retrospectively investigated the nighttime and daytime BP before and at least 3 months after OSA surgery. Paired test was used to compare the changes of BP before and after surgery. Generalized estimating equation was used to examine the prognostic significance of the variables in predicting the changes of postoperative BP.

RESULTS

In total, 176 patients with OSA (149 men, 27 women; mean age, 42.9 years; mean apnea/hypopnea index, 43.1/h) were enrolled in this study. The overall nighttime and daytime BP decreased significantly before and after OSA surgery (daytime systolic BP was reduced from 137.3 ± 14.0 mm Hg to 132.7 ± 17.0 mm Hg, < .01; nighttime systolic BP was reduced from 138.7 ± 16.0 mm Hg to 133.7 ± 15.3 mm Hg, < .01; daytime diastolic BP was reduced from 87.7 ± 14.7 mm Hg to 84.9 ± 10.6 mm Hg, = .01; nighttime diastolic BP was reduced from 85.4 ± 12.9 mm Hg to 83.1 ± 11.1 mm Hg, = .02). The changes of nighttime systolic and diastolic BP were significantly associated with the improvement of percentage of O saturation <90% during polysomnography.

CONCLUSION

Surgical modifications of the upper airways for patients with OSA could benefit blood pressure.

摘要

目的

研究阻塞性睡眠呼吸暂停低通气综合征(OSA)患者上气道手术后血压的变化。

设计

病例系列,图表回顾。

地点

三级学术医疗中心。

患者和方法

入选接受上气道手术的 OSA 患者。我们回顾性调查了 OSA 手术前和至少 3 个月后的夜间和日间血压。配对 t 检验用于比较手术前后血压的变化。广义估计方程用于检验变量预测术后血压变化的预后意义。

结果

共纳入 176 例 OSA 患者(149 例男性,27 例女性;平均年龄 42.9 岁;平均呼吸暂停/低通气指数 43.1/h)。OSA 手术后,夜间和日间血压均显著下降(日间收缩压从 137.3±14.0mmHg 降至 132.7±17.0mmHg, <.01;夜间收缩压从 138.7±16.0mmHg 降至 133.7±15.3mmHg, <.01;日间舒张压从 87.7±14.7mmHg 降至 84.9±10.6mmHg, =.01;夜间舒张压从 85.4±12.9mmHg 降至 83.1±11.1mmHg, =.02)。夜间收缩压和舒张压的变化与多导睡眠图中 90%以下血氧饱和度改善的百分比显著相关。

结论

OSA 患者上气道手术的改变可以有益于血压。

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