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阻塞性睡眠呼吸暂停低通气综合征对非体外循环冠状动脉旁路移植术患者术后并发症的影响。

Effects of obstructive sleep apnea hypopnea syndrome on postoperative complications in patients who undergo off-pump coronary artery bypass grafting.

作者信息

Gao Mingxin, Wang Pengcheng, Tang Tian, Yu Wenyuan, Yu Yang, Wei Yongxiang

机构信息

Department of Cardiac Surgery, Beijing An Zhen Hospital, Capital Medical University, Beijing, 100029, China.

Department of Otolaryngology, Beijing An Zhen Hospital, Capital Medical University, Beijing, 100029, China.

出版信息

Sleep Breath. 2022 Dec;26(4):1897-1905. doi: 10.1007/s11325-022-02649-4. Epub 2022 Jun 1.

DOI:10.1007/s11325-022-02649-4
PMID:35648334
Abstract

PURPOSE

To investigate the prevalence of obstructive sleep apnea hypopnea syndrome (OSAHS) in patients undergoing off-pump coronary artery bypass grafting (OPCABG) and analyze the effects of OSAHS on the incidence of post-OPCABG complications, length of stay in intensive care unit (ICU) and hospitalization, and hospital expense.

MATERIALS AND METHODS

This prospective study included patients undergoing OPCABG at Beijing An Zhen hospital from January 2018 to December 2018. OSAHS was diagnosed by using a portable sleep monitor before surgery.

RESULTS

Among 74 patients, the prevalence of OSAHS and moderate to severe OSAHS (apnea hypopnea index (AHI) ≥ 15) was 70% and 53%, respectively. Compared with the no to mild OSAHS group (AHI < 15), the moderate to severe OSAHS group presented a lower ejection fraction (P = 0.013). Between these two groups, the incidence of post-OPCABG complications; the duration of intubation, ICU stay, and hospitalization; and the hospital expense did not differ. Notably, the ejection fraction was significantly negatively correlated with the duration of ICU stay and hospital expense.

CONCLUSIONS

Patients undergoing OPCABG with severe OSAHS are likely to exhibit a low ejection fraction and poor heart function, which may require a longer ICU stay and incur higher hospital expenses.

摘要

目的

探讨非体外循环冠状动脉搭桥术(OPCABG)患者中阻塞性睡眠呼吸暂停低通气综合征(OSAHS)的患病率,并分析OSAHS对OPCABG术后并发症发生率、重症监护病房(ICU)住院时间和总住院时间以及住院费用的影响。

材料与方法

本前瞻性研究纳入了2018年1月至2018年12月在北京安贞医院接受OPCABG的患者。术前使用便携式睡眠监测仪诊断OSAHS。

结果

74例患者中,OSAHS的患病率为70%,中重度OSAHS(呼吸暂停低通气指数(AHI)≥15)的患病率为53%。与无至轻度OSAHS组(AHI<15)相比,中重度OSAHS组的射血分数较低(P = 0.013)。两组之间,OPCABG术后并发症的发生率、插管时间、ICU住院时间和总住院时间以及住院费用并无差异。值得注意的是,射血分数与ICU住院时间和住院费用显著负相关。

结论

接受OPCABG且患有重度OSAHS的患者可能表现出低射血分数和心功能较差,这可能需要更长的ICU住院时间并产生更高的住院费用。

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Sleep Breath. 2022 Sep;26(3):1115-1123. doi: 10.1007/s11325-021-02475-0. Epub 2021 Sep 6.
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