睡眠呼吸暂停患者的早期诊断对麻醉效能的 评价

Early Diagnosis of Sleep Apnea in Patients with Anesthetic Efficacy Evaluation

摘要: 目的：探讨睡眠呼吸暂停综合征患者术前使用便携式睡眠监测仪早期诊断对全麻过程中氧合指标的影响。方法：选取我院2024年9月~2025年3月来我院进行膀胱镜检查手术的患者为研究对象，通过术前使用便携式睡眠监测仪，将患者分为患有睡眠呼吸暂停综合征的患者(30例)；无睡眠呼吸暂停综合征患者纳入对照组(30例)术中连续监测脑氧饱和度、HR、BP、SpO2、BIS。记录两组患者从清醒到意识消失所需要的时间，同时记录两组患者麻醉恢复期意识从消失到清醒的时间。并记录两组术前(T0)、气管插管前5 min (T1)、气管插管后5 min (T2)、手术开始后5 min (T3)、拔除气管导管30 min (T4)氧合指标。结果：两组清醒到意识消失所需要的时间及麻醉恢复期意识恢复的时间比较。与没有睡眠呼吸暂停综合征的患者相比，术前存在睡眠呼吸暂停综合征患者意识消失的时间和麻醉恢复期的时间相比明显延长(P < 0.05)。两组患者的脑氧饱和度监测结果显示，患有睡眠呼吸暂停综合征的患者的脑氧饱和度值在T0、T1、T2、T3、T4几个时间点明显低于没有睡眠呼吸暂停综合征的患者，且差别具有统计学意义。结论：术前使用便携式睡眠检测仪早期诊断睡眠呼吸暂停综合征患者，能提供及早的术前评估和诊断，制定精准的麻醉方案，降低手术患者的并发症与死亡率，具有重要的理论和临床意义。

Abstract: Objective: To investigate the effect of early diagnosis of sleep apnea syndrome patients using portable sleep monitor before operation on oxygenation index during general anesthesia. Methods: The patients who came to our hospital for cystoscopy from September 2024 to March 2025 were selected as the research object, and the patients were divided into 30 patients with sleep apnea syndrome by using portable sleep monitor before operation. Patients with non-sleep apnea syndrome were included in the control group (30 cases), and cerebral oxygen saturation, HR, BP, SpO2 and BIS were continuously monitored during operation. The time required for patients in the two groups to disappear from consciousness was recorded, and the time for patients in the two groups to disappear from consciousness during anesthesia recovery was also recorded. The oxygenation indexes were recorded before operation (T0), 5 min before tracheal intubation (T1), 5 min after tracheal intubation (T2), 5 min after operation (T3) and 30 min after tracheal intubation (T4). Results: The time from waking to consciousness disappearance and the time of consciousness recovery during anesthesia recovery were compared between the two groups. Compared with patients without sleep apnea syndrome, the time of consciousness disappearance of patients with sleep apnea syndrome before operation was significantly longer than that of anesthesia recovery period (P < 0.05). The monitoring results of cerebral oxygen saturation of patients in the two groups showed that the cerebral oxygen saturation of patients with sleep apnea syndrome was significantly lower than that of patients without sleep apnea syndrome at T0, T1, T2, T3 and T4, and the difference was statistically significant. Conclusion: Early diagnosis of patients with sleep apnea syndrome by using portable sleep detector before operation can provide early preoperative evaluation and diagnosis, formulate accurate anesthesia scheme, and reduce the complications and mortality of surgical patients, which has important theoretical and clinical significance.