腹腔镜袖状胃切除术对肥胖型阻塞性睡眠呼吸暂停综合征中期疗效的临床研究

目的:探讨腹腔镜袖状胃切除术(LSG)对肥胖型阻塞性睡眠呼吸暂停综合征(OSAHS)的疗效,并分析其影响因素。方法:回顾分析2017年1月至2018年7月行腹腔镜袖状胃切除术的37例肥胖型阻塞性睡眠呼吸暂停综合征患者的临床资料及随访资料,分析此术式对患者体重及OSAHS的控制情况,并采用单因素与多因素Logistic回归分析影响体重及OSASH控制效果的相关因素。结果:共37例患者完成手术并定期随访至术后12个月,患者术后体重指数呈下降趋势,额外体重减轻百分率达73.2%;阻塞性睡眠呼吸暂停综合征治疗有效率达91.89%,呼吸暂停低通气指数、夜间最低血氧浓度较术前均呈现明显改善趋势;单因素分析显示,性别、体重、额外体重减轻百分率、吸烟可影响LSG对OSAHS的疗效(P<0.05),额外体重减轻百分率、吸烟是影响LSG治疗病态性肥胖疗效的独立因素之一。结论:LSG可有效降低肥胖患者多余体重,具有可靠的减重疗效,同时对OSAHS患者具有良好的中期疗效,吸烟及额外体重减轻百分率可能是影响手术疗效的因素。

A clinical study of the mid-term efficacy of laparoscopic sleeve gastrectomy for obese obstructive sleep apnea-hypopnea syndrome

Objective:To explore the efficacy of laparoscopic sleeve gastrectomy(LSG) for obstructive sleep apnea-hypopnea syndrome(OSAHS) in obese atients and to identify the related factors affecting its efficacy.Methods:The clinical and follow-up data of 37 obese patients with OSAHS who underwent LSG from Jan.2017 to Jul.2018 were analyzed retrospectively.The effect of this operation on patients’ weight and OSAHS was studied,and the factors affecting weight and OSAHS were examined through univariate and multivariate logistic regression analysis.Results:Operations of 37 patients were successful and patients were followed up over 12 months,their body mass index decreased,and the percentage of excess weight loss(EWL%) reached 73.2%;additionally,the rate of successful OSAHS treatment reached 91.89%,and the apnea-hypopnea index and lowest arterial oxygen saturation increased significantly.Univariate logistic regression analysis showed that gender,weight,EWL% and smoking affected the efficacy of LSG against OSAHS(P<0.05).EWL% and smoking were independent factors that helped determine the efficacy of LSG against morbid obesity(P<0.05).Conclusions:LSG can effectively help obese patients lose excess weight and shows medium-term efficacy against OSAHS in obese people.Smoking and EWL% appear to be the factors determining the efficacy of LSG.