在手术患者中阻塞性睡眠呼吸暂停的影响:系统性审查
Ioana-Medeea Titu1,2,3, Damiana Maria Vulturar2,4, Ana Florica Chis2,4
1Department of Surgery, Iuliu Hatieganu University of Medicine and Pharmacy, 400000 Cluj-Napoca, Romania.
阻塞性睡眠呼吸暂停 (OSA) 显著增加了手术风险,导致更多的并发症. 早期查和管理,包括CPAP,可以减少术后问题,但需要更多的研究才能得到一致的护理.
科学领域:
- 睡眠医学 睡眠医学
- 麻醉学 麻醉学
- 外科手术的结果
背景情况:
- 阻塞性睡眠呼吸暂停 (OSA) 是常见的和低诊断,造成实质性的外科手术期间风险.
- 患有OSA的患者在减肥,骨科,心脏和耳鼻喉手术后面临并发症的风险增加.
研究的目的:
- 系统地审查被诊断为OSA的发病率和对外科手术结果的影响.
- 评估OSA患者的术前查和术后管理策略.
主要方法:
- 在PubMed (2013-2024) 的系统文献搜索中,遵循PRISMA指南.
- 包括成年外科患者的OSA,经过多睡眠学确认.
- 使用牛津证据医学中心框架评估的方法质量.
主要成果:
- OSA显著增加了呼吸系统抑郁,心房动,AKI,妄想和长时间住院的风险.
- 在心脏和腹部外科手术中,CPAP疗法显示出好处,但由于附着性问题,在骨科和耳鼻喉科手术中产生了不一致的效果.
- 当与诊断确认相结合时,STOP-BANG等术前查工具是有用的.
结论:
- 在手术患者中,OSA是一个显著的,可修改的风险因素.
- 术前鉴定和量身定制的管理,包括CPAP,可以降低术后发病率.
- 进一步的RCT和成本效益研究是必要的,以优化OSA在手术中的管理途径.
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