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目的:探讨UPPP术后24h内并发症的发生率及其危险因素,为早期预防术后并发症的发生提供理论依据。方法:回顾性分析162例接受UPPP手术的阻塞性睡眠呼吸暂停低通气综合征(OSAHS)患者,按照有无发生术后并发症进行分组,比较2组患者术前及术中各项临床指标的差异,对重要的临床参数作单因素及多元逐步Logistic回归分析。结果:31例(19.1%)患者术后24h内出现并发症,包括呼吸并发症21例(13.0%),心血管并发症6例(3.7%),术后出血9例(5.6%)。并发症组和无并发症组之间在BMI、AHI、LSAT及困难插管等方面均差异有统计学意义(均P<0.05)。多因素回归分析显示,BMI(OR=1.136)、AHI(OR=4.828)及困难插管(OR=1.971)为术后24h内出现并发症的独立危险因素。结论:OSAHS患者术前BMI、AHI及麻醉困难插管是预测术后24小时内出现并发症的主要指标。对于肥胖、严重OSAHS患者及插管困难患者,应提高警惕,做好围术期处理,避免术后并发症的发生。
Objective: To investigate the incidence of complications and its risk factors within 24h after UPPP, and provide a theoretical basis for early prevention of postoperative complications. Methods: A retrospective analysis of 162 patients with obstructive sleep apnea-hypopnea syndrome (OSAHS) undergoing UPPP surgery was performed. Patients were divided into groups according to the presence or absence of postoperative complications. The clinical parameters of the two groups were compared before and after surgery Differences, the important clinical parameters for single factor and multiple stepwise Logistic regression analysis. RESULTS: Thirty-one patients (19.1%) had complications within 24 hours after operation, including 21 respiratory complications (13.0%), 6 cardiovascular complications (3.7%) and 9 postoperative bleeding (5.6%). There were significant differences in BMI, AHI, LSAT and difficult intubation between the complication group and the non-complication group (all P <0.05). Multivariate regression analysis showed that BMI (OR = 1.136), AHI (OR = 4.828), and difficult intubation (OR = 1.971) were independent risk factors for complication within 24 hours after operation. Conclusion: Preoperative BMI, AHI and anesthesia intubation in patients with OSAHS are the main indicators to predict the occurrence of complications within 24 hours after operation. For obesity, severe OSAHS patients and patients with intubation difficulties, should be vigilant, do a good job perioperative management, to avoid postoperative complications.