目的 对阻塞性睡眠呼吸暂停和困难气道之间的关联性进行Meta分析,为临床处理提供参考。方法 检索2000-01-01至2018-12-31 Pubmed、ProQuest Central、EMBASE、Medline、Cochrane Online Library和Web of Science的前瞻性研究的文献,对阻塞性睡眠呼吸暂停(obstructive sleep apnea, OSA)患者和非OSA患者中发生困难气道的情况进行Meta分析。结果 与非OSA患者相比,OSA患者发生困难插管、困难面罩通气以及困难插管合并困难面罩通气的OR值分别为2.86 (95% CI:2.30～3.56, P＜0.01; 12.81% vs 2.37% )、3.37(95% CI:2.82～4.03, P＜0.01; 3.87% vs 1.01% )和3.78(95% CI: 3.26～4.38, P＜0.01;1.08% vs 0.30% )。结论 OSA患者发生困难气道的风险显著高于非OSA患者。
Abstract
Objective To evaluate whether the difficult airway associate with obstructive sleep apnea.Methods Articles were searched from the Pubmed, Medline, Google scholar, ProQuest Central, Cochrane Online Library and Web of Science from January 1st 2000 to October 31st 2018 for prospective trials. RevMan5.1.7 was used to analysis the association of difficult airway with obstructive sleep apnea.Results Compare with the non-OSA patients, the OR of the difficult intubation, difficult mask ventilation and difficult airway combined with difficult mask ventilation in OSA patients were 2.86, 3.37 and 3.78, respectively.Conclusions The OSA patients have much higher risk of difficult airway incidence.
关键词
阻塞性睡眠呼吸暂停 /
困难气道 /
困难插管 /
困难面罩通气
Key words
obstructive sleep apnea /
difficult airway /
difficult intubation /
difficult mask ventilation
{{custom_sec.title}}
{{custom_sec.title}}
{{custom_sec.content}}
参考文献
[1] 李金志, 吴 丹, 王 伟. 麻醉医师对慢性阻塞性睡眠呼吸暂停低通气综合征认知情况的调查[J]. 中外医学研究, 2017, 14(15): 64-65.
[2] Ramachandran S K,Mathis M R,Tremper K K,et al. Predictors and clinical outcomes from failed Laryngeal Mask Airway Unique: a study of 15,795 patients[J]. Anesthesiology, 2012, 116(6): 1217-1226.
[3] Kheterpal S,Healy D,Aziz M F,et al. Incidence, predictors, and outcome of difficult mask ventilation combined with difficult laryngoscopy: a report from the multicenter perioperative outcomes group[J]. Anesthesiology, 2013, 119(6): 1360-1369.
[4] Gokay P,Tastan S,Orhan M E. Is there a difference between the STOP-BANG and the berlin obstructive sleep apnoea syndrome questionnaires for determining respiratory complications during the perioperative period?[J]. J Clin Nurs, 2016, 25(9-10): 1238-1252.
[5] Corso R M, Petrini F, Buccioli M, et al. Clinical utility of preoperative screening with STOP-Bang questionnaire in elective surgery[J]. Minerva Anestesiol, 2014, 80(8): 877-884.
[6] Brodsky J B,Lemmens H J, Brock-Utne J G,et al. Morbid obesity and tracheal intubation[J]. Anesth Analg, 2002, 94(3): 732-736.
[7] Kheterpal S,Han R,Tremper K K,et al. Incidence and predictors of difficult and impossible mask ventilation[J]. Anesthesiology, 2006, 105(5): 885-891.
[8] Chung F, Yegneswaran B, Herrera F, et al. Patients with difficult intubation may need referral to sleep clinics[J]. Anesth Analg, 2008, 107(3): 915-920.
[9] Kheterpal S, Martin L, Shanks A M, et al. Prediction and outcomes of impossible mask ventilation: a review of 50,000 anesthetics[J]. Anesthesiology, 2009, 110(4): 891-897.
[10] Shah P N, Sundaram V. Incidence and predictors of difficult mask ventilation and intubation[J]. J Anaesthesiol Clin Pharmacol, 2012, 28(4): 451-455.
[11] Toshniwal G, McKelvey G M, Wang H. STOP-Bang and prediction of difficult airway in obese patients[J]. J Clin Anesth, 2014, 26(5): 360-367.
[12] Acar H V, Yarkan U H, Kaya A, et al. Does the STOP-Bang, an obstructive sleep apnea screening tool, predict difficult intubation?[J]. Eur Rev Med Pharmacol Sci, 2014, 18(13): 1869-1874.
[13] Opperer M, Cozowicz C, Bugada D, et al. Does obstructive sleep apnea influence perioperative outcome? A qualitative systematic review for the society of anesthesia and sleep medicine task force on preoperative preparation of patients with sleep-disordered breathing[J]. Anesth Analg, 2016, 122(5): 1321-1334.
[14] 林 娜, 李彦如, 李天佐,等. 阻塞性睡眠呼吸暂停低通气综合征患者围术期上气道评估[J]. 首都医科大学学报, 2013, 5(34): 646-650.
[15] 穆娟娟,刘江华. 阻塞性睡眠呼吸暂停低通气综合征手术的麻醉方法分析[J]. 心理医师, 2017, 26(23): 101-102.
[16] Fouladpour N, Jesudoss R, Bolden N, et al. Perioperative complications in obstructive sleep apnea patients undergoing surgery: a review of the legal literature[J]. Anesth Analg, 2016, 122(1): 145-151.
[17] Kim J A, Lee J J. Preoperative predictors of difficult intubation in patients with obstructive sleep apnea syndrome[J]. Can J Anaesth, 2006, 53(4): 393-397.
PDF(1500 KB)
