持续正压通气对重度阻塞性睡眠呼吸暂停低通气综合征行悬雍垂腭咽成形术患者疗效及睡眠结构的影响

Effect of continuous positive airway pressure on the efficacy and sleep structure of patients with severe obstructive sleep apnea hypopnea syndrome undergoing uvulopalatopharyngoplasty

  • 摘要:
      目的  探讨持续正压通气对重度阻塞性睡眠呼吸暂停低通气综合征(OSAHS)行悬雍垂腭咽成形术(UPPP)患者疗效及睡眠结构的影响。
      方法  将40例重度OSAHS患者随机分为对照组与持续正压通气(CPAP)组。对照组采取改良UPPP治疗, CPAP组在对照组基础上进行CPAP治疗。比较2组患者治疗前、治疗后6个月的多导睡眠监测(PSG)结果,包括每小时呼吸暂停低通气指数(AHI)、血氧饱和度最小值(LSaO2)、最长呼吸暂停时间(LAT)。比较2组患者治疗前后睡眠结构和睡眠质量。
      结果  治疗后, 2组患者的AHI和LAT均显著降低(P < 0.05), LSaO2显著增加(P < 0.05), 且CPAP组的变化显著更大(P < 0.05)。治疗后, 2组患者1~2期占比和微觉醒指数均显著降低(P < 0.05), 3~4期和快动眼睡眠期(REM)占比均显著增加(P < 0.05), 其中CPAP组的变化显著更大(P < 0.05)。治疗后,对照组与CPAP组的PSQI评分均较治疗前显著降低(P < 0.05), 且CPAP组变化显著更大(P < 0.05)。
      结论  CPAP能够有效提高重度OSAHS患者改良UPPP术后的治疗效果,改善患者的睡眠结构和睡眠质量。

     

    Abstract:
      Objective  To explore the effect of continuous positive airway pressure (CPAP) on the efficacy and sleep structure of patients with severe obstructive sleep apnea hypopnea syndrome (OSAHS) undergoing uvulopalatopharyngoplasty (UPPP).
      Methods  Totally 40 patients with severe OSAHS were randomly divided into control group and continuous positive airway pressure (CPAP) group. Patients in the control group were treated with modified UPPP, and CPAP group was treated with CPAP on the basis of the control group. Polysomnography (PSG) monitoring results were compared between the two groups before and 6 months after treatment, including apnea hypopnea index (AHI) per hour, minimum blood oxygen saturation (LSaO2) and maximum apnea time (LAT). The sleep structure and sleep quality before and after treatment were compared between the two groups.
      Results  After treatment, AHI and LAT in both groups significantly decreased (P < 0.05), LSaO2 significantly increased (P < 0.05), and the changes in CPAP group were significantly greater (P < 0.05). After treatment, the proportion of phase 1 to 2 and micro-arousal index in both groups decreased significantly (P < 0.05), the proportion of phase 3 to 4 and REM increased significantly (P < 0.05), and the changes in CPAP group were significantly greater (P < 0.05). After treatment, the PSQI scores of the control group and CPAP group were significantly lower than those before treatment (P < 0.05), and the changes of CPAP group were significantly greater (P < 0.05).
      Conclusion  CPAP can effectively improve the therapeutic effect of patients with severe OSAHS by modified UPPP and improve the sleep structure and sleep quality.

     

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