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目的 :探讨阻塞性睡眠呼吸暂停综合征 (obstructivesleepapneasyndrome ,OSAS)患者手术治疗的麻醉处理。方法 :72例OSAS患者手术前先正压通气治疗 (continuepositiveairwaypressure ,CPAP)和评价上气道 ,5 5例患者经鼻或经口气管插管全身麻醉 ;在手术完毕患者完全清醒后拔除插管。结果 :72例患者中 ,轻度 16例、中度 2 4例、重度 32例。合并有晨起高血压 2 8例 ,心电图均有不同程度心肌缺血的表现 ;红细胞增多症 12例 ;腭咽平面Ⅰ级 9例、Ⅱ级 2 4例、Ⅲ级的 2 7例、Ⅳ级 12例。术前 3~ 5d行自动调压正压通气治疗(Auto -CPAP) ,经口气管内插管 4 8例 ,经鼻气管内插管 6例 ,均无术中插管困难和术后高血压危象 ,呼吸道梗阻发生。结论 :充分认识OSAHS患者全身麻醉的手术风险 ,术前CPAP治疗和上气道评估 ,术中正确处理、严格掌握气管内插管、术后拔管的时机 ,是保证OSAHS患者手术成功、麻醉安全的关键
Objective: To investigate the surgical treatment of anesthesia in patients with obstructive sleep apnea syndrome (OSAS). METHODS: Seventy-two OSAS patients underwent positive airway pressure (CPAP) before surgery and upper airway aspiration. Fifty-five patients underwent nasal or orotracheal intubation for general anesthesia. Intubation was performed after the patients were completely awake. Results: Among the 72 patients, 16 were mild, 24 were moderate and 32 were severe. There were 28 cases with early morning hypertension, electrocardiogram showed different degrees of myocardial ischemia; 12 cases of polycythemia; velopharyngeal plane Ⅰ in 9 cases, Ⅱ 24 cases, Ⅲ Ⅲ 27 cases, Ⅳ 12 cases. Auto-CPAP was performed 3 to 5 days before operation. There were 48 cases of oral intubation and 6 cases of endotracheal intubation. There were no intraoperative intubation difficulties and postoperative hypertension Like, respiratory obstruction occurs. Conclusion: To fully understand the surgical risk of general anesthesia in OSAHS patients, preoperative CPAP treatment and upper airway assessment, intraoperative correct treatment, strict control of endotracheal intubation, and the timing of extubation are to ensure the successful operation and safe anesthesia of OSAHS patients key