阻塞性睡眠呼吸暂停评分和潮末二氧化碳水平在接受口咽手术的青少年儿童中的重要性

Hayel zer, lker m, Tolga zl
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摘要

目的梗阻性睡眠呼吸暂停患儿术后发生不良呼吸事件的风险增加。在我们的研究中,我们使用改良的STOP-Bang问卷计算接受口咽手术的儿童的阻塞性睡眠呼吸暂停评分。比较两组患者术中面罩通气水平、术后并发症及术后ETCO2水平。方法选取拟行口咽手术的90例患者,年龄7-15岁,ASA分级为I-II级,术前检查采用改良的STOP-Bang问卷。根据改良的STOP-Bang问卷测定阻塞性睡眠呼吸暂停评分(osa),并将患者分为低、中、高危3组。术中发现口罩通气水平困难。在手术结束时,记录患者拔管后0、3、5、10、15分钟的潮末二氧化碳浓度(ETCO2)值及患者是否有痉挛。结果在修改后的STOP-Bang问卷的8个参数中,除打鼾和学习障碍外,其余6个参数组间差异均有统计学意义。从第一组到第三组,困难面罩通气明显增加。I组与II组、II组与III组、I组与III组之间存在显著差异(p= 0.001)。结论改进后的STOP-Bang问卷结果与困难面罩通气所需的干预水平之间存在相关性,该信息可作为今后患者围手术期提高护理水平的有用指标
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THE IMPORTANCE OF OBSTRUCTIVE SLEEP APNEA SCORE AND END-TIDAL CO2 LEVEL IN ADOLESCENT CHILDREN WHO UNDERWENT OROPHARYNGEAL SURGERY
Aim Children with obstructive sleep apnea have an increased postoperative risk of adverse respiratory events. In our study, we calculated Obstructive Sleep Apnea Scores using the modified STOP-Bang questionnaire in children undergoing oropharyngeal surgery. The groups determined according to this score were compared in terms of mask ventilation levels in the intraoperative period, postoperative complications and postoperative ETCO2 levels. Methods A total of 90 patients, aged 7-15 years, who will undergo oropharyngeal surgery, classified as ASA I-II, and who have undergone a modified STOP-Bang questionnaire at the preoperative examination, were included in the study. Obstructive sleep apnea score (OSAs) was determined according to the modified STOP-Bang questionnaire, and the patients were divided into 3 groups as low, medium, and high-risk. Difficult mask ventilation level was noted in the intraoperative period. At the end of the operation, end-tidal carbon dioxide concentration (ETCO2) values at 0, 3, 5, 10, and 15 minutes after the patient was extubated and whether the patient had spasms were recorded. Results Among the 8 parameters in the modified STOP-Bang questionnaire, it was found that there was a significant difference between the groups for the other 6 parameters except for snoring and learning disability. Diffucult mask ventilation increased significantly from Group I to Group III. There is a significant difference between Group I and II, Group II and III, and Group I and Group III (p= 0.001). Although there were small differences within the groups and between the measurements of ETCO2 at different minutes, these differences were not statistically significant (p≥0.05) Conclusion In conclusion, associations between the results of the modified STOP-Bang questionnaire and the level of intervention required for difficult mask ventilation, this information could serve as a useful indicator for a higher level of care in the perioperative period for future patients
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