伴有多脏器损害的极重度阻塞性睡眠呼吸暂停低通气综合征治疗体会

目的:探讨极重度阻塞性睡眠呼吸暂停低通气综合征(OSAHS)伴有多脏器损害有效的治疗方法.方法:2007年6月～2008年2月,对6例伴有多脏器损害的呼吸紊乱指数(AHI)≥65 次/h的极重度OSAHS患者首先行气管切开术,再根据伴发疾病情况和上气道阻塞的不同位置进行同期或分期手术.结果:6例术后未出现窒息、出血以及心脑血管意外等并发症,带管1～16周拔管,6个月后随诊,夜间打鼾、呼吸抑制症状有不同程度改善,多脏器损害情况得到有效控制;复查多导睡眠监测(PSG)2例显效,4例有效.结论:极重度OSAHS伴有多脏器损害患者的治疗,首先要行气管切开术,再针对不同的患者进行个体化综合治疗.

Therapeutic Modalities for Extremely Severe OSAHS Patients Accompanied by Multiorgan Injuries

Objective：To explore the effective therapy for extremely severe OSAHS patients accompanied by multi - organ injuries. Methods：From June 2007 to February 2008,7 cases of extremely severe OSAHS with multi - organ injuries whose AHI were no less than 65 times per hour had received individual comprehensive therapy and their clinical data were analyzed. 6 cases underwent tracheotomy first, and then they were given one - stage or different - stage operation on the basis of their accompanied diseases and different obstructional locations of upper airway. Results：No complications such as suffocation, hemorrhage, cardio - cerebral vascular accident appeared in 6 patients. Trachea cannulas of these 6 cases were pulled out in 1 to 16 weeks after operation. 6 months after surgery, the symptoms such as snoring and respiratory restraint had improved obviously and the condition of muhi - organ damage was controlled effectively. PSG results showed that 2 cases were excellent, 4 cases were valid. Conclusions ： Traeheotomy is the first stage treatment for extremely severe OSAHS patients with multi -organ injuries, and then individual comprehensive therapy should be given to different cases.