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首页> 外文期刊>Otolaryngology--head and neck surgery: official journal of American Academy of Otolaryngology-Head and Neck Surgery >Is postoperative intensive care monitoring necessary after uvulopalatopharyngoplasty?
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Is postoperative intensive care monitoring necessary after uvulopalatopharyngoplasty?

机译：葡萄膜上睑咽喉整形术后是否需要进行术后重症监护？

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We conducted a retrospective review of 347 consecutive patients who underwent surgical treatment for obstructive sleep apnea syndrome. We analyzed perioperative data to identify the nature and rate of complications in an attempt to determine whether intensive care unit monitoring is needed after uvulopalatopharyngoplasty (UPPP) and associated procedures including septoplasty, tonsillectomy, turbinate reduction, geniohyoid advancement, and tracheostomy. In the 347 cases, 14 complications occurred (4%), including 5 involving the airway, 5 postoperative hemorrhages, and 4 complications classed as "other," including dehiscence of a tracheostomy flap, abdominal ileus, urine retention, and increased creatinine concentration. We found no difference between preoperative lowest oxygen saturation and oxygen-saturation readings in the postoperative period and no correlation between complication rate and apnea severity. An association was detected between multiple simultaneous procedures and the development of complications: 50% of the patients in whom complications developed had undergone nasal procedures along with UPPP, compared with only 15% of the patients without complications. Except for one patient, all complications that occurred on the surgical ward were treated without transfer to the intensive care unit. Although surgery on the upper airway must be performed with caution in patients with sleep apnea, our findings suggest that UPPP is a safe procedure and that postoperative monitoring in an intensive care setting is not necessary for most patients.
机译：我们回顾性分析了347例因阻塞性睡眠呼吸暂停综合症而接受手术治疗的患者。我们分析围手术期的数据，以确定并发症的性质和发生率，以试图确定在进行睑板lat咽成形术（UPPP）以及相关的程序（包括隔膜成形术，扁桃体切除术，鼻甲减少术，舌骨弓样进展和气管切开术）后是否需要加强监护病房。在这347例病例中，发生了14例并发症（占4％），包括5例涉及气道，5例术后出血和4例归类为“其他”的并发症，包括气管造口术瓣裂开，腹部回肠，尿retention留和肌酐浓度升高。我们发现术前最低血氧饱和度和血氧饱和度读数之间无差异，并发症发生率和呼吸暂停严重程度之间也没有相关性。在多个同时进行的手术与并发症的发展之间发现了关联：发生并发症的患者中有50％的患者接受了UPPP鼻腔手术，而没有并发症的患者只有15％。除一名患者外，所有在外科病房发生的并发症都得到了治疗，没有转移到重症监护室。尽管对于睡眠呼吸暂停患者，必须谨慎进行上呼吸道手术，但我们的研究结果表明，UPPP是一种安全的程序，对于大多数患者而言，在重症监护室进行术后监护并不是必需的。

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