减肥手术后阻塞性睡眠呼吸暂停综合征的演变:一项观察性回顾研究。

Corentin Puech, Jérémie Thereaux, Francis Couturaud, Christophe Leroyer, Cécile Tromeur, Christophe Gut-Gobert, Charles Orione, Raphaël Le Mao, Cécile L'hévéder
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引用次数: 0

摘要

背景:对大多数患者来说,减肥手术后阻塞性睡眠呼吸暂停综合征(OSAS)的缓解似乎很有希望,但这种缓解并不一定与体重下降呈线性相关。之前的小规模研究指出,年龄较小和术前体重低于 100 公斤是阻塞性睡眠呼吸暂停综合症好转的预测因素:主要目的是评估使用持续气道正压(CPAP)治疗的患者 OSAS 的演变情况。此外,我们还试图确定手术后 OSAS 改善的潜在预测因素:法国布列斯特医院,大学医院:在这项回顾性观察研究中,我们分析了 2015 年 1 月至 2021 年 12 月期间接受减肥手术的 44 名患者。每位患者在手术前后都接受了呼吸多导图(RP)或多导睡眠图(PSG)检查。我们收集了干预前和干预后 6 个月内的 CPAP 数据(包括有效压力和依从性):在研究人群中,68.18% 的患者的 OSAS 状况有所改善,即每小时呼吸暂停-低通气指数低于 15。手术前较高的平均血氧饱和度是预测 OSAS 改善的唯一因素。坚持使用 CPAP 和治疗压力值这两个很少被研究的参数在病情好转和病情未好转的患者之间并无显著差异:手术后OSAS缓解率为68.18%,只有手术前平均血氧饱和度较高才是OSAS缓解的预测因素。
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Evolution of treated obstructive sleep apneas syndrome after bariatric surgery: an observational retrospective study.

Background: The resolution of obstructive sleep apneas syndrome (OSAS) following bariatric surgery appears to be promising for the majority of patients although this resolution does not necessarily exhibit a linear correlation with weight loss. Previous small-scale studies have pinpointed a younger age and preoperative weight under 100kg as predictive factors of OSAS improvement OBJECTIVES: The primary objective was to evaluate the evolution of OSAS in patients treated with continuous positive airway pressure (CPAP). Additionally, we tried to identify potential predictive factors for OSAS improvement postsurgery.

Setting: Brest Hospital, France, University Hospital.

Methods: In this retrospective, observational study we analyzed a cohort of 44 patients who underwent bariatric surgery, between January 2015 and December 2021. Each patient underwent respiratory polygraphy (RP) or polysomnography (PSG) before and after the surgical procedure. We collected CPAP data (including effective pressure and adherence) before and during the 6 months following the intervention.

Results: Within the study population, 68.18% of patients exhibited improved OSAS, as defined as an apnea-hypopnea index of less than 15 per hour. A higher mean oxygen saturation prior to surgery emerged as the sole predictive factor for OSAS improvement. CPAP adherence and therapeutic pressure value, 2 rarely studied parameters, did not show significant difference between improved and nonimproved patients.

Conclusions: The rate of OSAS resolution after surgery is 68.18%, with only a higher mean oxygen saturation before surgery identified as a predictive factor for OSAS resolution.

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