阻塞性睡眠呼吸暂停低通气综合征改良悬雍垂腭咽成形术围手术期处理的回顾性研究

发布时间：2018-01-09 01:18

本文关键词：阻塞性睡眠呼吸暂停低通气综合征改良悬雍垂腭咽成形术围手术期处理的回顾性研究　出处：《广西医科大学》2014年硕士论文　论文类型：学位论文

【摘要】：目的：通过对阻塞性睡眠呼吸暂停低通气综合征(OSAHS)行改良悬雍垂腭咽成形术（UPPP）患者围手术期临床资料的回顾性研究，探讨OSAHS患者围手术期处理的合理方法。方法：收集我院2008年2月至2013年12月耳鼻咽喉头颈外科本病组连续收治的149例成人OSAHS患者围手术期的临床资料；其中由同一位术者对130例有手术适应症的患者进行了改良UPPP；对患者的伴发病、并发症等相关的临床资料进行了统计分析，并结合相关因素进行讨论。结果：伴发病共59例（65例次），占39.59%；因术前伴发病及其它原因未能进行手术的患者共19例，占12.75%；手术后并发症共25例次，占19.23%，术后延迟拔管4例次（另有3例为术前评估预留）；原发性出血2例次，继发性出血2例次；心脑血管意外4例次（其中脑干出血死亡1例）；继发性高血压12例次，发热1例次；术后无发生呼吸困难者，也无需要气管切开病例。并发症发生率与手术方法无关联（P＞0．05)，但使用单极电刀切除能有效缩短手术时间、减少术中出血量（P＜0．05)。结论：OSAHS为全身疾病，术前伴发病应该得到合理的处理，进行改良UPPP必须严格掌握手术适应证；术后并发症可以发生在伤口完全愈合前的任何时段，术后严密的观察和对并发症及时合理的处理可以避免严重事件的出现。结合个体制定适合的治疗方案，加强和重视围手术期的处理，是UPPP术疗效和手术安全的保证。
[Abstract]:Objective : To explore the rational method of perioperative management of patients with obstructive sleep apnea - hypoventilation syndrome ( Obstructive Sleep Apnea Syndrome ) in patients with obstructive sleep apnea - vulopalatopharyngoplasty ( UPPP ) . Methods : The clinical data of 149 adult patients with obstructive sleep apnea syndrome in our hospital from February 2008 to December 2013 were collected . The clinical data of 130 patients with surgical indications were modified by the same surgeon . The clinical data of patients with concomitant diseases and complications were statistically analyzed and the related factors were discussed . Results : A total of 59 cases ( 65 cases ) , accounting for 39.59 % , had a total of 19 cases ( 12.75 % ) of patients who had failed to operate before operation and other reasons . Conclusion : There should be a reasonable treatment before operation , and the modified UPPP should strictly grasp the indications of operation . The postoperative complications can occur at any time before the wound is completely healed . The postoperative complications can avoid the occurrence of serious events . Combined with the individual development of appropriate treatment plan , the treatment of perioperative period is strengthened and attention . It is the guarantee of the curative effect and surgical safety of UPPP .

【学位授予单位】：广西医科大学
【学位级别】：硕士
【学位授予年份】：2014
【分类号】：R766

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