减肥手术治疗肥胖患者阻塞性睡眠呼吸暂停的效果。

Silvia Matarredona Quiles, Marina Carrasco Llatas, Paula Martínez Ruíz de Apodaca, Jose Ángel Díez Ares, Elena González Turienzo, José Dalmau Galofre
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引用次数: 0

摘要

目的:分析减肥手术治疗肥胖患者阻塞性睡眠呼吸暂停(OSA)的成功率及其相关因素。方法:纵向、前瞻性、单队列研究,连续抽样18-65岁的OSA患者进行减肥手术干预。对OSA进行回顾性分析,术前和术后进行全上气道探查和心肺多导图(CRP)检查。结果:本研究纳入了57例患者。减肥手术治疗OSA的总体手术成功率和治愈率分别为61.4%和52.6%。预测成功的因素为女性(OR = 12.54;CI95% = 1.75 ~ 89.88, p = 0.012),年龄小于53岁(OR = 7.24;CI95% = 1.48 ~ 35.51, p = 0.015),术前体重小于105 kg (OR = 8.1;CI95% = 1.44-45.62, p = 0.018)。手术成功的患者体重和体质指数较低,体重减轻幅度较大,术后颈围较小,腭带较少,但这些不是多因素分析中的独立因素。结论:我们的研究结果表明,减肥手术是肥胖患者OSA治疗的一种可行的选择,女性、年轻、瘦弱患者的成功率更高。此外,UA上的脂肪组织已被证明由于体重减轻而减少,尽管与OSA治疗的手术成功无关。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Effect of bariatric surgery in the treatment of obstructive sleep apnea in obese patients.

Purpose: To analyze the success rate of bariatric surgery in the treatment of obstructive sleep apnea (OSA) in obese patients and its related factors.

Methods: Longitudinal, prospective, single cohort study, with consecutive sampling including OSA patients aged 18-65 years intervened of bariatric surgery. An anamnesis regarding OSA, a complete upper airway (UA) exploration and a cardiorespiratory polygraphy (CRP) pre- and post-surgery were performed.

Results: Fifty-seven patients were included in this study. The overall surgical success and cure rates for bariatric surgery as a treatment for OSA were 61.4% and 52.6%, respectively. Factors predicting success were female sex (OR = 12.54; CI95% = 1.75-89.88, p = 0.012), age below 53 years old (OR = 7.24; CI95% = 1.48-35.51, p = 0.015) and pre-surgical weight below 105 kg (OR = 8.1; CI95% = 1.44-45.62, p = 0.018). Surgical success cases had lower weight and body mass index, greater weight loss, smaller postsurgical neck circumference and less palatal webbing, however these were not independent factors in the multivariate analysis.

Conclusions: Our results show that bariatric surgery is a feasible option for OSA treatment in obese patients, with a higher success rate in female, younger and thinner patients. Moreover, adipose tissue on the UA has been proven to decrease as a result of weight loss, although not correlated with surgery success in the treatment of OSA.

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