摘要
目的探讨人工冬眠疗法对重度阻塞性睡眠呼吸暂停低通气综合征(OSAHS)患者术后带气管插管期间的镇静效果及其应用安全性。方法我科2000年6月—2010年6月收治重度OSAHS 28例,行悬雍垂腭咽成形术(UPPP)9例,韩氏-悬雍垂腭咽成形术(H-UPPP)19例,术后带气管插管期间给予冬眠合剂镇静,并于用药前、用药期间(用药后10 min、1 h、6 h)、拔除气管插管后监测平均动脉压(MAP)、心率(HR)、呼吸频率(RR)、脉搏血氧饱和度(SpO2)及血气分析指标。结果用药期间至拔除气管插管后,HR、MAP、RR均明显低于用药前(P<0.05,P<0.01);与用药前比较,用药后1、6 h SpO2显著提高(P<0.01),pH值调整至正常范围(P<0.05,P<0.01),而氧分压和二氧化碳分压无明显变化(P>0.05)。用药期间至拔除气管插管后未发生呼吸道梗阻等严重并发症。高血压患者应用冬眠合剂后均无需予降压药,血压即能控制在正常范围。结论冬眠合剂在重度OSAHS术后带气管插管期间使用安全、有效,镇静、镇痛效果好,能有效减少严重术后并发症的发生。
Objective To explore the abirritative effect and applied security of artificial hibernation in postoperative tracheal intubations patients with severe obstructive sleep apnea hypopnea syndrome（OSAHS）.Methods Among 28 patients during June 2000 and June 2010 in our hospital with severe OSAHS,9 received uvulopalatopharyngoplasty（UPPP） and 19 Han-uvulopalatopharyngoplasty（H-UPPP）.The patients were treated with nasotracheal intubation and habination postoperatively.The mean arterial pressure（MAP）,heart rate（HR）,respiration rate（RR）,pulse oximetry（SpO2） and blood gas analysis were monitored respectively before,during and after administration（10 min,1 h,6 h after administration） and after tracheal extubation.Results During treatment to tracheal extubation the HR,MAP and RR were significantly lower than those before treatment（P〈0.05）.Compared with the index before treatment,SpO2 significantly increased 1 and 6 h after administration（P〈0.01）,pH adjusted to the normal range（P〈0.05,P〈0.01）,but there was no significant difference in PO2 and PCO2（P〉0.05）.No serious complications such as respiratory tract obstruction occurred during treatment to tracheal extubation.The patients with high blood pressure were treated with cockstailytic which could control the blood pressure within normal limits without antihypertensive agent.Conclusion For postoperative patients with severe OSAHS in duration of endotracheal intubation,the cockstailytic is safe and effective,and has good postoperative sedation and analgesia effects,which can avoid severe postoperative complications.
出处
《解放军医药杂志》
CAS
2012年第7期22-24,共3页
Medical & Pharmaceutical Journal of Chinese People’s Liberation Army
关键词
睡眠呼吸暂停
阻塞性
插管术
气管内
低温
人工
手术后并发症
Sleep apnea, obstructive
Intubation, endotracheal
Hypothermia, artificial
Postoperative compli-cations
