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计划接受减肥手术的病态肥胖患者肥胖相关通气不足的分期

Staging of obesity-associated hypoventilation in patients with morbid obesity scheduled for bariatric surgery.

作者信息

Kania Aleksander, Tęczar Justyna, Celejewska-Wójcik Natalia, Major Piotr, Polok Kamil

机构信息

2nd Department of Medicine, Department of Pulmonology, Faculty of Medicine, Jagiellonian University Medical College, Kraków, Poland.

2nd Department of General Surgery, Jagiellonian University Medical College, Kraków, Poland.

出版信息

Chron Respir Dis. 2025 Jan-Dec;22:14799731251338269. doi: 10.1177/14799731251338269. Epub 2025 Apr 25.

Abstract

Almost 20% of Polish citizens aged >15 years are obese and this number is increasing. Numerous obesity-associated diseases include, quite notably, also sleep-related breathing disorders and hypoventilation. This study aimed to analyse the prevalence of obesity hypoventilation syndrome (OHS) and hypoventilation staging in a group of patients qualified for bariatric surgery within the Comprehensive Specialist Care in Bariatrics (KOS-BAR) pilot program designed and running in Poland since 2021. Prior to the bariatric procedure, the participants were referred to a pulmonologist for assessment. We retrospectively analysed the records of 134 patients. Almost all of the tested bariatric patients ( = 122, 91.0%) had obstructive sleep apnea mainly classified as severe (59.0%). Hypoventilation was confirmed in 30 patients (22.4%), and in 37.9% of them, increased levels of serum bicarbonate were found. Chronic diurnal hypercapnia was confirmed in 7.9% of patients (10/122). Hypoventilation as well as obstructive sleep apnea in the obese population is a significant issue. The presented study group included patients in stages 0-IV of obesity-associated hypoventilation. The conducted analysis suggests that the most common form of hypoventilation among patients qualified for bariatric surgery is obesity-associated sleep hypoventilation (stage I).

摘要

近20%的15岁以上波兰公民患有肥胖症,且这一数字正在上升。许多与肥胖相关的疾病,相当显著地,还包括与睡眠相关的呼吸障碍和通气不足。本研究旨在分析自2021年起在波兰设计并运行的肥胖症综合专科护理(KOS-BAR)试点项目中,符合减肥手术条件的一组患者中肥胖低通气综合征(OHS)的患病率和通气不足分期。在进行减肥手术之前,参与者被转诊至肺科医生处进行评估。我们回顾性分析了134例患者的记录。几乎所有接受测试的减肥手术患者(n = 122,91.0%)都患有阻塞性睡眠呼吸暂停,主要分类为重度(59.0%)。30例患者(22.4%)被证实存在通气不足,其中37.9%的患者血清碳酸氢盐水平升高。7.9%的患者(10/122)被证实存在慢性日间高碳酸血症。肥胖人群中的通气不足以及阻塞性睡眠呼吸暂停是一个重大问题。本研究组包括肥胖相关通气不足0-IV期的患者。所进行的分析表明,符合减肥手术条件的患者中最常见的通气不足形式是肥胖相关睡眠低通气(I期)。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ae2a/12034952/6d4e00372d0a/10.1177_14799731251338269-fig1.jpg

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