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目的回顾分析阻塞性睡眠呼吸暂停低通气综合征(obstructive sleep apnea and hypopnea syndrome,OSAHS)患者麻醉恢复室(post-anesthesia care unit,PACU)处理的临床资料,提高围术期安全性,降低并发症。方法分析我院东区PACU收治的96例OSAHS患者,对镇静镇痛方式、呼吸机治疗、监测手段进行总结。结果患者年龄26~62岁,体重70~112kg,呼吸暂停/低通气指数(AHI)≥40,合并高血压37例、糖尿病12例,心电图检查示ST段或T波改变22例,左心室高电压17例,完全性右束支传导阻滞9例。所有患者术后均保留经鼻气管插管PACU过夜,1例患者拔管后再插管入ICU治疗,其余患者术后第2天晨拔管返回病房,均未发生术后知晓、气管切开、术后出血。结论重症OSAHS患者术后给予合理镇静镇痛留置气管导管过夜是安全和快速恢复的理想方式。
Objective To review the clinical data of post-anesthesia care unit (PACU) in patients with obstructive sleep apnea and hypopnea syndrome (OSAHS), to improve perioperative safety and reduce complications . Methods 96 cases of OSAHS patients admitted to PACU in the eastern district of our hospital were analyzed and the methods of sedation and analgesia, ventilator treatment and monitoring were summarized. Results The patients were 26 to 62 years of age, weighing 70 to 112 kg, apnea / hypoglycemia index (AHI) ≥40, hypertension complicated in 37 cases and diabetes mellitus in 12 cases. Electrocardiogram showed that ST segment or T wave changed in 22 cases and left ventricular hypertrophy Voltage in 17 cases, complete right bundle branch block in 9 cases. All patients were treated with nasal endotracheal intubation PACU overnight, one patient after intubation into the ICU extubation, the rest of the morning after 2 days of extubation return to the ward, were not known after surgery, tracheotomy , Postoperative bleeding. Conclusion Severe OSAHS patients with reasonable sedation and analgesia after tracheal catheter stay overnight is the ideal way to recover safely and quickly.