阻塞性睡眠呼吸暂停和心脏外科手术的结果:通过元分析合成进行系统审查 (PROSPERO CRD420251049574)
Andrei Raul Manzur1,2,3, Alina Gabriela Negru4, Andreea-Roxana Florescu1,2
1Department of Doctoral Studies, "Victor Babes" University of Medicine and Pharmacy Timisoara, Eftimie Murgu Square No. 2, 300041 Timisoara, Romania.
Biomedicines
|July 29, 2025
概括
阻塞性睡眠呼吸暂停 (OSA) 显著增加心脏手术患者的风险,导致更多的并发症,如心房动和更长的住院时间. 建议在手术前进行常规的OSA查,以改善患者的治疗结果.
科学领域:
- 心脏病学 心脏病学
- 肺部病理学 肺部病理学
- 麻醉学 麻醉学
背景情况:
- 阻塞性睡眠呼吸暂停 (OSA) 是患有心脏手术的患者常见的,往往未被诊断的疾病.
- 心脏手术包括冠状动脉旁路移植 (CABG),大动脉置换 (AVR) 和心心修复/置换 (MVR).
研究的目的:
- 系统地审查和元分析OSA与术后并发症和死亡率之间的关联.
- 评估心脏手术患者OSA查工具的预测价值.
主要方法:
- 在PubMed的系统文献搜索 (2025年4月) 寻找过去十年内的研究.
- 包括17项用于定性综合的初级研究和4项用于元分析的初级研究.
- 评估结果,包括心房动,MACCE,AKI,呼吸系统问题,肺炎,住院时间 (LOS) 和死亡率.
主要成果:
- 在OSA患者中,元分析显示,心房动 (OR=2.44),MACCE (OR=2.06),AKI (OR=2.24) 和呼吸道并发症 (OR=1.15) 的几率显著更高.
- OSA患者在医院的LOS显著长 (SMD=0.62),肺炎风险略有增加 (OR=1.07).
- 关于中风,ICU住院和死亡率的数据不一致或有限.
结论:
- 在心脏手术中,OSA是显著的风险因素,与术后并发症增加和延长住院治疗有关.
- 结果支持将OSA查纳入手术前评估.
- 需要进一步的试验来评估术后管理,如CPAP,以改善结果.
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