鼻咽管对阻塞性睡眠呼吸暂停综合征患者悬雍垂腭咽成形术后第一晚睡眠低氧血症的缓解作用。
Nasopharyngeal tube effects on alleviating sleep hypoxemia during the first night following velopharyngeal surgery in patients with obstructive sleep apnea syndrome.
机构信息
Department of Otolaryngology, Head and Neck Surgery, Peking University First Hospital, Beijing, China.
出版信息
J Clin Sleep Med. 2023 Feb 1;19(2):303-308. doi: 10.5664/jcsm.10252.
STUDY OBJECTIVES
To investigate the feasibility and effectiveness of nasopharyngeal tube (NPT) insertion in alleviating sleep hypoxemia during the first night after velopharyngeal surgery in patients with obstructive sleep apnea syndrome (OSAS).
METHODS
In this prospective nonblinded, randomized, controlled study, 46 patients with obstructive sleep apnea syndrome (OSAS) who underwent velopharyngeal surgery were enrolled and randomly allocated to the control group (with no NPT insertion) and the NPT insertion group. Both groups underwent overnight pulse oximetry tests during the first postoperative night.
RESULTS
One patient in the NPT insertion group was excluded because of involuntary self-removal of NPT during sleep. A total of 45 patients with OSAS were included for analysis, with 23 in the control group and 22 in the NPT insertion group. No significant differences in preoperative baseline information were found between the two groups. Compared with the patients in the control group, those patients in the NPT insertion group showed a significantly higher value of the lowest oxygen saturation of oximetry during the first postoperative night (85.0 ± 4.0% vs 79.3 ± 8.0%) ( = .005). The percentage of patients with lowest oxygen saturation of oximetry < 80% in the NPT insertion group was only 9.1% (2 of 22), which was significantly lower than 39.1% (9 of 23) in the control group ( = .035). No patient reported unbearable discomfort related to NPT insertion. The most common mild discomfort was occasional pharyngeal foreign body sensation (6 of 22, 27.3%).
CONCLUSIONS
NPT insertion could lessen the severity of sleep hypoxemia during the first night after velopharyngeal surgery in patients with OSAS and showed excellent compliance. This method could be a potential alternative option for decreasing the risks of complications related to severe sleep hypoxemia during the early postoperative days.
CITATION
Zhang J, Guan S, Zhang C, Du X, Li T, Xiao S. Nasopharyngeal tube effects on alleviating sleep hypoxemia during the first night following velopharyngeal surgery in patients with obstructive sleep apnea syndrome. . 2023;19(2):303-308.
研究目的
探讨经鼻气管插管（NPT）在缓解阻塞性睡眠呼吸暂停综合征（OSAS）患者悬雍垂腭咽成形术后第一晚睡眠低氧血症中的可行性和有效性。
方法
这是一项前瞻性非盲、随机、对照研究，纳入了 46 例接受悬雍垂腭咽成形术的阻塞性睡眠呼吸暂停综合征（OSAS）患者，并随机分为对照组（无 NPT 插入）和 NPT 插入组。两组患者均在术后第一晚进行整夜脉搏血氧饱和度测试。
结果
NPT 插入组中有 1 例患者因睡眠时非自愿自行拔出 NPT 而被排除。共纳入 45 例 OSAS 患者进行分析，其中对照组 23 例，NPT 插入组 22 例。两组患者术前基线资料无统计学差异。与对照组患者相比，NPT 插入组患者术后第一晚最低血氧饱和度值明显较高（85.0±4.0%比 79.3±8.0%）（ =.005）。NPT 插入组中最低血氧饱和度<80%的患者比例仅为 9.1%（2/22），明显低于对照组的 39.1%（9/23）（ =.035）。无患者报告与 NPT 插入相关的无法忍受的不适。最常见的轻度不适是偶尔的咽部异物感（22 例中有 6 例，27.3%）。
结论
NPT 插入可减轻 OSAS 患者悬雍垂腭咽成形术后第一晚睡眠低氧血症的严重程度，且具有良好的顺应性。这种方法可能是降低术后早期严重睡眠低氧血症相关并发症风险的潜在替代选择。
引文
Zhang J, Guan S, Zhang C, Du X, Li T, Xiao S. Nasopharyngeal tube effects on alleviating sleep hypoxemia during the first night following velopharyngeal surgery in patients with obstructive sleep apnea syndrome.. 2023;19(2):303-308.
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