Study On The Dynamically Monitoring And Influencing Factors Of Sleep In Perioperative Patients With Enhanced Recovery After Hepatobiliary Surgery

Objective:1.To confirm the clinical application value of sleep monitoring bracelet in sleep monitoring and evaluation by comparing the differences in sleep parameters of the same patient between the sleep monitoring bracelet and polysomnography.2.To dynamically monitor the sleep status of perioperative patients with enhanced recovery after hepatobiliary surgery through the utilization of sleep monitoring bracelets,and explore the related factors affecting sleep time of the patients.On the one hand,it provides a theoretical basis for the formulation of sleep management strategies of the patients.On the other hand,it provides sleep-related information for developing the consensus guidelines of enhanced recovery after hepatobiliary surgery.Methods:1.Fifty-two patients with obstructive sleep apnea hypopnea syndrome in the Department of Respiratory and Sleep Medicine of one third-grade class-A hospital in Shandong Province were selected by using the convenient sampling method.The sleep monitoring bracelet and polysomnography were used to monitor their sleep status overnight and the differences were compared in sleep parameters such as total sleep time,deep sleep time and light sleep time.2.The convenience sampling method was used to select 256 patients who treated by enhanced recovery after hepatobiliary surgery in one third-grade class-A hospital in Shandong Province from July 2018 to June 2019.The sleep monitoring bracelet was used to monitor the sleep duration of these patients.The comprehensive questionnaire for sleep-related factors in patients with enhanced recovery after hepatobiliary surgery,Mishel’s Uncertainty in Illness Scale-Adult and Connor-Davidson Resilience Scale were used to investigate and analyze the influencing factors of perioperative sleep duration.Results:1.The total sleep time,deep sleep time,light sleep time and rapid eye movement sleep time monitored by the sleep monitoring bracelet were(395.44±57.72)min,(58.81 ±29.97)min,(257.77±47.82)min and(78.87±26.45)min,respectively.These parameters monitored by the polysomnography were(397.03±52.00)min,(57.99±29.59)min,(258.59±46.68)min and(80.45±24.91)min,respectively.There was no significant difference in monitored sleep parameters between the sleep monitoring bracelet and the polysomnography(P>0.05).2.The incidence rates of sleep insufficiency in the perioperative period of patients with enhanced recovery after hepatobiliary surgery on the first day,the preoperative day,the surgery day and the first day after surgery were 63.3%,72.7%,53.9%and 64.8%,respectively.The incidence rate of perioperative sleep insufficiency(the average night sleep time of each study subject on the first day,the preoperative day,the surgery day and the first day after surgery was less than 7 hours)was 75.4%.3.The univariate analysis showed that there were significant differences between the perioperative normal sleep group and the insufficient sleep group in gender,operation methods,surgical grade,postoperative anus exhaust time,utilization of drainage tube,perioperative pain score,uncertainty score in illness and psychological resilience(P<0.05).4.The multivariate analysis showed that perioperative pain,uncertainty in illness and psychological resilience were the independent factors of perioperative sleep insufficiency in patients with enhanced recovery after hepatobiliary surgery,the OR values were 13.184,1.096 and 0.109,respectively(P<0.05).Conclusion:1.There is no significant difference in the monitored sleep parameters between sleep monitoring bracelet and polysomnography.Consequently,the sleep monitoring bracelet can be used for long-term monitoring and evaluation of sleep conditions.2.The sleep status in the perioperative period of patients with enhanced recovery after hepatobiliary surgery is not optimistic.The incidence of perioperative sleep insufficiency is still at a high level,and the patients have the worst nighttime sleep on the day before surgery.3.The sleep status in the perioperative period of patients with enhanced recovery after hepatobiliary surgery are influenced by a variety of factors,such as gender,operation methods,surgical grade,postoperative anus exhaust time,utilization of drainage tube,perioperative pain score,uncertainty score in illness and psychological resilience.However,there are three independent influencing factors.Among them,perioperative pain and uncertainty in illness are risk factors for perioperative sleep insufficiency,and psychological resilience is a protective factor for perioperative sleep insufficiency.