Sleep disturbances detected by a sleep apnea monitor in craniofacial surgical patients
Sleep disturbances detected by a sleep apnea monitor in craniofacial surgical patients
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DOI：
10.1097/01.scs.0000200410.22583.07
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发表时间：
2006-01-01
影响因子：
0.9
通讯作者：
Hirano, A
中科院分区：
文献类型：
--
作者：
Akita, S;Anraku, K;Hirano, A
对颅颌面外科手术中的睡眠呼吸暂停进行了调查。在1999年1月至2003年12月期间，18例患者在手术前后至少间隔6个月进行测量。8例患者接受腭裂修复术，10例患者接受正颌手术、综合征性颅缝早闭和咽后瓣手术。研究中的所有患者都表现出阻塞性睡眠呼吸暂停的临床体征，如打鼾和睡眠期间呼吸停止。呼吸暂停监测仪用于术前和术后睡眠呼吸暂停状态，通过测量：1）睡眠时的位置; 2）经皮血氧饱和度; 3）呼吸分析，如呼吸暂停-呼吸不足的类型、事件频率和呼吸暂停-呼吸不足的持续时间; 4）心率; 5）打鼾分析，如训练、时间、平均值以及最小和最大放大。术后呼吸暂停低通气指数（AHI）显著改善，尤其是在非腭裂手术的病例中（术前和术后分别为7.4 ± 8.73/h和1.6 ± 0.43/h; P < 0.05，不包括腭裂手术）。打鼾占总睡眠的百分比也显著改善（手术前和手术后分别为22.4 +/- 19.74%和9.0 +/-8.54%;所有患者P < 0.01）。因此，睡眠呼吸暂停参数的变化在颅面手术中得到阐明。虽然有打鼾和解剖异常，但腭裂手术并不一定会加重睡眠呼吸暂停状态。咽部皮瓣的分离改善了睡眠呼吸暂停，双颌前移在使睡眠呼吸暂停正常化方面是有效的。
Sleep apnea in craniofacial surgery was investigated. Between January 1999 and December 2003, 18 patients were measured at an at least 6-month interval before and after surgery. Eight patients underwent palatoplasty for cleft palate, and the other 10 patients underwent orthognathic surgery, syndromic craniosynostosis, and postpharyngeal flap surgery. All patients included in the study demonstrated clinical signs of obstructive sleep apnea, such as snoring and cessation of breathing during sleep. An apnomonitor was used for presurgical and postsurgical sleep apnea status by measuring: 1) position during sleep; 2) percutaneous oxygen saturation; 3) respiratory analysis, such as the type of apnea-hypopnea, frequency of the events, and duration of apnea-hypopnea; 4) heart rate; and 5) snore analysis, such as trains, time, mean, and minimal and maximal amplifications. The apnea-hypopnea index (AHI) was significantly improved after surgery, especially in cases other than palatoplasty (7.4 +/- 8.73/h and 1.6 +/- 0.43/h, before and after surgery, respectively; P < 0.05 excluding palatoplasty). The percentage of snoring to total sleep was also improved significantly (22.4 +/- 19.74% and 9.0 +/- 8.54%, before and after surgery, respectively; P < 0.01 in all patients). Therefore, changes in sleep apnea parameters were elucidated in craniofacial surgery. Palatoplasty did not necessarily worsen the sleep apnea status, although there were snoring and anatomic abnormalities. Detachment of the pharyngeal flaps improved sleep apnea, and bi-maxillary advancement was effective in normalizing sleep apnea.