杨珵璨 王兵

    摘 要 阻塞性睡眠呼吸暂停低通气综合征(obstructive sleep apnea hypopnea syndrome， OSAHS)是一种发病隐匿的慢性、潜在致死性疾病，也是病态肥胖症的最常见合并症之一。由于面颅软硬组织解剖结构异于西方人种，东亚人种的OSAHS患病率更高，且程度更严重。减重代谢手术对肥胖合并OSAHS的治疗作用已获公认，但现减重代谢外科医师对OSAHS的认知仍严重不足。对减重代谢外科患者进行OSAHS筛查是完全必要且可行的，多导睡眠监测是诊断OSAHS的金标准。本文就减重代谢手术的术前正压通气治疗，术中气道管理、麻醉注意事项、麻醉药物选择、患者体位选择和手术方式选择等问题作一阐述，而整个诊治过程的标准化无疑可使更多的患者受益。

    关键词 减重代谢手术 阻塞性睡眠呼吸暂停低通气综合征 肥胖

    中图分类号： R656.61； R563.8 文献标志码：A 文章编号：1006-1533(2021)11-0003-03

    Metabolic and bariatric surgery for obesity combined with obstructive sleep apnea hypopnea syndrome

    YANG Chengcan， WANG Bing*

    (Department of General Surgery， Shanghai Ninth Peoples Hospital， Shanghai Jiao Tong University School of Medicine， Shanghai 200011， China)

    ABSTRACT Obstructive sleep apnea hypopnea syndrome (OSAHS) is a chronic and potentially fatal disease with insidious onset and one of the most common complications of morbid obesity. The prevalence of OSAHS in East Asian races is higher and the severity is more serious than Western races because of the difference in the anatomical structure. The effect of metabolic and bariatric surgery (MBS) on obesity combined with OSAHS has been recognized ......