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口腔或口咽癌患者切除和重建手术后睡眠参数的可能变化。

Probable Change of Sleep Parameters after Resection and Reconstruction Surgeries in Patients with Oral Cavity or Oropharyngeal Cancers.

机构信息

Department of Otolaryngology, Chang Gung Memorial Hospital, Chiayi 61363, Taiwan.

Sleep Center of Chang Gung Memorial Hospital, Chiayi 61363, Taiwan.

出版信息

Biomed Res Int. 2021 Oct 1;2021:7408497. doi: 10.1155/2021/7408497. eCollection 2021.

Abstract

In patients of oral cavity or oropharyngeal cancers, resection of the tumor and reconstruction of the defect may reduce the framework, add a bulky flap, alter the tissue flexibility, and contribute to postoperative obstructive sleep apnea (OSA). Postoperative OSA and the potential consequences may decrease the survival rate and reduce patients' quality of life. It is unclear whether the surgery is associated with postoperative OSA. Here, we compared the polysomnographies (PSGs) before and after the surgery in 15 patients of oral cavity or oropharyngeal cancers (out of 68 patients of head and neck cancers) without a chemo- or radio-therapy. Each patient received the second PSG before the start of any indicated adjuvant therapy to prevent its interference. There were 14 men and 1 woman, with a mean age and a standard deviation (SD, same in the following) of 56.2 ± 12.8 years. There were 6 tongue cancers, 5 buccal cancers, 2 tonsil cancer, 1 lower gum cancer, and 1 trigone cancer. The results show that the surgery changed sleep parameters insignificantly in apnea-hypopnea index (AHI), mean oxyhemoglobin saturation of pulse oximetry (SpO2), minimum SpO2, mean desaturation, and desaturation index but increased mean heart rate in the patients with free flaps. These results hint that the effect of surgery on developing OSA was small in this sample, with a longer plate or a larger framework for a bulkier free flap. It needs future studies with a large sample size to generalize this first observation.

摘要

在口腔或口咽癌患者中,肿瘤切除和缺损重建可能会减少框架,增加大块皮瓣,改变组织柔韧性,并导致术后阻塞性睡眠呼吸暂停(OSA)。术后 OSA 及其潜在后果可能会降低生存率并降低患者的生活质量。目前尚不清楚手术是否与术后 OSA 有关。在这里,我们比较了 15 例口腔或口咽癌患者(68 例头颈部癌症患者中的 15 例)手术前后的多导睡眠图(PSG),这些患者未接受化疗或放疗。每位患者在开始任何有指征的辅助治疗前都接受了第二次 PSG,以防止其干扰。这些患者中有 14 名男性和 1 名女性,平均年龄和标准差(SD,下同)为 56.2±12.8 岁。其中有 6 例舌癌、5 例颊癌、2 例扁桃体癌、1 例下牙龈癌和 1 例三角区癌。结果表明,手术对睡眠参数的改变不明显,包括呼吸暂停低通气指数(AHI)、脉搏血氧饱和度仪的平均血氧饱和度(SpO2)、最低 SpO2、平均血氧饱和度下降和血氧饱和度下降指数,但增加了游离皮瓣患者的平均心率。这些结果表明,在该样本中,手术对 OSA 的发展影响较小,但对于较大的游离皮瓣,可能需要更长的固定板或更大的框架。需要进一步的研究来扩大这一初步观察。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7be4/8500743/af86e1819f2e/BMRI2021-7408497.001.jpg

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