Sugerman H J, Fairman R P, Lindeman A K, Mathers J A, Greenfield L J
Ann Surg. 1981 Jun;193(6):677-85. doi: 10.1097/00000658-198106000-00002.
Three patients with the obesity hypoventilation syndrome and one patient with the sleep apnea syndrome underwent gastroplasty for weight reduction. A tracheostomy was also performed in the patient with sleep apnea. The PaO2 rose from an average of 51 +/- 9 to 71 +/- 5 torr and the PaCO2 fell from an average of 51 +/- 21 to 41 +/- 6 torr within two to ten months following bariatric surgery. The improved arterial blood gases were associated with an increased forced vital capacity in each patient. The change in maximum voluntary ventilation was variable. Sleep capneography demonstrated cure of the patient with sleep apnea permitting removal of the tracheostomy. All four patients have returned to productive lives in society. Given proper pre- and postoperative care, patients with respiratory insufficiency tolerate the operation well. Respiratory insufficiency associated with morbid obesity should be considered an indication for the gastroplasty procedure, rather than a contraindication as previously suggested.
三名肥胖低通气综合征患者和一名睡眠呼吸暂停综合征患者接受了胃成形术以减轻体重。患有睡眠呼吸暂停的患者还进行了气管造口术。在减肥手术后两到十个月内，动脉血氧分压（PaO2）从平均51±9托升至71±5托，动脉血二氧化碳分压（PaCO2）从平均51±21托降至41±6托。改善的动脉血气与每名患者用力肺活量增加有关。最大自主通气量的变化各不相同。睡眠二氧化碳描记术显示睡眠呼吸暂停患者治愈，可拔除气管造口管。所有四名患者都已恢复正常的社会生产生活。给予适当的术前和术后护理，呼吸功能不全的患者对手术耐受性良好。与病态肥胖相关的呼吸功能不全应被视为胃成形术的适应证，而非如先前所认为的禁忌证。
