目的 采用STOP-BANG量表筛查深度镇静下行胃结肠镜检查术的受试者中阻塞性睡眠呼吸暂停(obstructive sleep apnea ,OSA)的患病率及对低氧血症风险的评估。方法 选择择期行无痛胃结肠镜检查患者,以STOP-BANG量表对患者进行评分,将受试者分为OSA高危组和低危组。通过靶控输注丙泊酚使患者进入深度镇静状态。比较OSA高危组和低危组发生低氧血症的发生率和辅助呼吸技术使用率。结果 共招募620例受试者,纳入614例。220例(35.8%)被划为OSA高危组,394例(64.1%)被划为低危组。85例(13.8%)在胃结肠镜检查过程当中出现低氧血症。高危组发生低氧血症的风险明显高于低危组(25.8% vs 7.3%);相对风险值(RR3.37,95% CI 2.22~5.13)。结论 深度镇静胃结肠镜检查的受试者OSA高危组发生低氧血症的风险更高, 辅助呼吸技术使用率也较高。
Abstract
Objective To estimate the prevalence of obstructive sleep apnea (OSA) among Chinese subjects undergoing deep sedation for screening gastrointestinal endoscopy and to assess the hypoxemia risk of these examinees stratified by the STOP-BANG Questionnaire.Methods A prospective cohort study was conducted among recipients of deep sedation with monitored anesthesia care for combined esophagogastroduodenoscopy plus colonoscopy. These subjects were stratified into high- and low-risk groups for OSA using the STOP-BANG Questionnaire. Deep sedation was achieved via a propofol target-controlled infusion system. The frequency of hypoxemia was compared between high-risk and low-risk groups for OSA.Results A total of 620 Chinese subjects were enrolled during the study, and 614 of them were included for analysis. 220 (35.8%) were classified as high risk for OSA, and 394 (64.1%) as low risk for OSA by the STOP-BANG Questionnaire. Hypoxemia occurred in 85 (13.8%) of these subjects during endoscopy. The high-risk group was at significantly higher risk for hypoxemia than the low-risk group (24.8% vs 7.3%; relative risk, 3.37; 95% CI, 2.22-5.13).Conclusions About 35.5% of Chinese subjects undergoing deep sedation for screening endoscopy are at high risk of OSA. Subjects at high risk of OSA are associated with increased risk of hypoxemia compared with the low-risk group.
关键词
胃结肠镜 /
深度镇静 /
低氧血症 /
阻塞性睡眠呼吸暂停 /
监测麻醉 /
STOP-BANG问卷
Key words
endoscopy /
deep sedation /
hypoxemia /
obstructive sleep apnea /
monitored anesthesia care /
STOP-BANG Questionnaire
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基金
原海军总医院创新培育基金 (CXPY201724)
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