Construction And Application Of Perioperative Management Scheme For OSAHS Patients Undergoing Weight Loss Surgery

Objective1.To construct a perioperative management scheme for OSAHS patients undergoing weight loss surgery.2.To evaluate the preliminary application effect of perioperative management scheme for OSAHS patients undergoing weight loss surgery.Methods1.In this study,the literature research method was applied to retrieve,evaluate,extract,summarize and review relevant literatures on perioperative management of patients with OSAHS treated by weight loss surgery according to the "6S" retrieval model of evidence level,so as to form the perioperative management plan for OSAHS patients.2.40 cases of OSAHS patients were selected as the study subjects for convenience sampling who were admitted to the Department of Weight Reduction and Metabolic Surgery in a Grade A hospital in Changsha from March to October 2020.Informed consent was given to them,baseline data were collected,admission and discharge standards were determined.The subjects were divided into control group(n=20)and experimental group(n=20)according to the time sequence of inclusion.Control group using conventional care,experimental group adopted on the basis of conventional nursing care plus manage new building management solution with the method of comparing two groups of patients with perioperative the vital signs,operation time,PACU,retention time,postoperative adverse events happening,length of hospital stay,medical cost,sleepiness,improve nursing satisfaction and the January.3.In this study,SPSS19.0 software was used for description and statistical analysis.For numerical variables,normality test and homogeneity test of variance were first carried out.If all groups met the normal distribution,ttest of two independent samples was used for inter-group comparison to calculate the mean and standard deviation().If the normality is not satisfied,the nonparametric Wilcoxon rank sum test is considered.χ2 test was used for statistical analysis of disordered classified data,and Wilcoxon rank sum test was used for statistical analysis of ordered data.The test level was α=0.05 on both sides.If P<0.05,the difference was statistically significant.sx ±Results1.Patients with OSAHS were treated with perioperative management plan for weight loss surgery.2.There were no statistically significant differences in gender,age,height,weight,BMI,waist circumference,abdominal circumference,waist-hip ratio,neck circumference,ASA classification and other general data between the two groups(P>0.05),indicating comparability.3.The comparison of vital signs between the following two groups including the intraoperative systolic blood pressure(SBP),diastolic blood pressure(DBP),heart rate,respiration,oxygen saturation and body temperature.The mean values of diastolic blood pressure(DBP),heart rate into anesthesia recovery room(PACU)and respiration into anesthesia recovery room(PACU)in the experimental group at 8h after surgery were lower than those in the control group,with statistical significance(P<0.05).4.By comparingthe blood gas analysis results between two groups,there was no statistical significance(P>0.05)in PH value,partial pressure of oxygen(PO2),total carbon dioxide,partial pressure of carbon dioxide(PCO2).5.The comparison of operative duration and retention time of PACU between the two groups are as follows: the operative duration and retention time of PACU in the experimental group were shorter than those in the control group,with statistical significance(P<0.05).6.The comparison of the incidence of postoperative adverse events between the two groups are as the follows: the incidence of increased respiratory secretions in the experimental group(0),the control group(5/20,25%),the experimental group was lower than the control group,the difference was statistically significant(P<0.05);Restlessness: the incidence of the test group(1/20,5%)was lower than that of the control group(6/20,30%),and the difference was statistically significant(P<0.05).Abnormal heart rate events in the experimental group(0),the control group(5/20,25%),the experimental group was lower than the control group,which means the difference was statistically significant(P<0.05).7.The comparison of the hospitalization days and hospitalization costs between the two groups are as follows:hospitalization days and hospitalization costs in theexperimental group were lower than those in the control group,with statistical significance(P<0.05).8.The comparison of satisfaction scores of hospitalized nursing between the two groups are as follows:the experimental group showed a higher satisfaction score,with statistical difference(P<0.0001).9.The comparison of the Epworth Narcolepsy Scale scores in the two groups one month after surgery are as the follows: the scores in the test group were lower than those in the control group,with statistical significance(P<0.05).Conclusion1.Construction of perioperative management plan for weight loss surgery in OSAHS patients,which provides evidence-based procedures and norms for weight loss surgery in OSAHS patients.2.The application of management plan is conducive to maintaining the stability of perioperative vital signs,reducing the duration of surgery and postoperative PACU stay,reducing hospitalization days,reducing hospitalization costs,reducing the occurrence of postoperative adverse events,improving patient care satisfaction,improving daytime sleepiness of OSAHS patients,and reducing the potential risk of death.