Roux-en-Y胃旁路术后阻塞性睡眠呼吸暂停严重程度、上气道表现及健康相关生活质量的变化：一项前瞻性前后对照研究
Changes in obstructive sleep apnea severity, upper-airway findings, and health-related quality of life after Roux-en-Y gastric bypass: a prospective before-and-after study.
文献信息
| PMID | 42955464 |
|---|---|
| 原文 | 在 PubMed 查看原文 ↗ |
| 发表日期 | 2026 |
| 作者 | Ligia Fernanda Sossa Bonilla |
| 作者单位 | Department of Otolaryngology, Hospital de San José, Universidad FUCS, Calle 10 No. 18-75, Bogotá, Colombia. |
| 期刊 | Sleep & breathing = Schlaf & Atmung |
| SCI 分区 | Q3 |
| IF | 2.8 |
| 研究类型 | 临床研究 · 临床 |
| 所属专科 | 咽喉科 |
中文摘要
目的： 评估肥胖成人接受Roux-en-Y胃旁路术后约6个月时阻塞性睡眠呼吸暂停（OSA）严重程度、上气道表现、日间嗜睡及健康相关生活质量的变化。
方法： 我们在哥伦比亚波哥大圣何塞医院开展了一项前瞻性单组前后对照研究。接受Roux-en-Y胃旁路术作为常规治疗的OSA成人患者接受了术前和术后多导睡眠监测、人体测量学和耳鼻咽喉科评估、鼻纤维喉镜检查以及患者报告指标。研究纳入标准要求术前AHI > 5次/小时。配对结局根据情况采用配对t检验、Wilcoxon符号秩检验或精确McNemar检验进行分析。
结果： 在评估的33例患者中，30例接受了手术，18例完成了两次客观评估。平均体重从104.4 ± 12.6 kg降至68.5 ± 8.9 kg，BMI从38.77 ± 4.94 kg/m²降至25.82 ± 4.28 kg/m²，AHI从23.70 ± 8.67次/小时降至8.74 ± 4.35次/小时；平均AHI变化为-14.96次/小时（95% CI -18.69至-11.22；p < 0.001）。15/18名参与者（83.3%；精确95% CI 58.6-96.4%）仍存在残余OSA（AHI ≥ 5次/小时）。若干上气道、嗜睡和生活质量指标也出现了有利变化。
结论： 在完成随访的参与者中，Roux-en-Y胃旁路术后OSA严重程度降低，次要结局也表现有利，但完全缓解并不常见。术后持续进行睡眠再评估仍然很重要。
临床试验注册： 不适用。这是一项观察性前后对照队列研究，未为研究目的前瞻性分配任何健康干预。
英文摘要
PURPOSE: To evaluate changes in obstructive sleep apnea (OSA) severity, upper-airway findings, daytime sleepiness, and health-related quality of life approximately 6 months after Roux-en-Y gastric bypass in adults with obesity.
METHODS: We conducted a prospective single-group before-and-after study at Hospital de San José, Bogotá, Colombia. Adults with OSA undergoing Roux-en-Y gastric bypass as routine care had pre- and postoperative polysomnography, anthropometric and otolaryngologic assessment, nasofibrolaryngoscopy, and patient-reported measures. Study eligibility required preoperative AHI > 5 events/h. Paired outcomes were analyzed with paired t, Wilcoxon signed-rank, or exact McNemar tests as appropriate.
RESULTS: Of 33 patients assessed, 30 underwent surgery and 18 completed both objective evaluations. Mean weight decreased from 104.4 ± 12.6 to 68.5 ± 8.9 kg, BMI from 38.77 ± 4.94 to 25.82 ± 4.28 kg/m², and AHI from 23.70 ± 8.67 to 8.74 ± 4.35 events/h; mean AHI change was - 14.96 events/h (95% CI - 18.69 to - 11.22; p < 0.001). Residual OSA (AHI ≥ 5 events/h) persisted in 15/18 participants (83.3%; exact 95% CI 58.6-96.4%). Several upper-airway, sleepiness, and quality-of-life measures also changed favorably.
CONCLUSION: Among participants with complete follow-up, Roux-en-Y gastric bypass was followed by lower OSA severity and favorable secondary outcomes, but complete remission was uncommon. Continued postoperative sleep reassessment remains important.
CLINICAL TRIAL REGISTRATION: Not applicable. This is an observational beforeandafter cohort study no health intervention was prospectively assigned for research purposes.