睡眠呼吸暂停综合征患者夜间睡眠呼吸参数的变化及护理对策(英文)

Nocturnal changes in sleeprespiratory variables in patients with obstructive sleep apnea and nursing interventions

目的：探讨睡眠呼吸暂停综合征（ＳＡＳ）患者夜间睡眠呼吸参数的变化及相应护理对策。方法：对１６例ＳＡＳ住院患者在治疗前、睡眠姿势训练、气道持续正压（ＣＰＡＰ）呼吸机治疗三种状态下，进行整夜多导睡眠仪监测。结果：在ＳＡＳ整夜呼吸紊乱中，零点以后其危险因素大大增加，出现严重低氧血症，血压升高，心律失常，尤其是呼吸暂停时间延长，次数增加。而侧卧位可显著地改善低氧血症，最低血氧饱和度（ＳａＯ２）从（６２±１９）％升高至（８３±１１）％（Ｐ＜０．０１），ＣＰＡＰ呼吸机治疗能使呼吸调节障碍得到明显的恢复，呼吸暂停由（４４．３±２２．６）次降至（０．２５±０．５４）次（Ｐ＜０．０１）。结论：护理上应密切观察病情变化，特别是零点以后应加强巡视，除观察呼吸运动外还应警惕脑血管病及心脏疾病的发生，对不具备ＣＰＡＰ呼吸机治疗条件者宜采取睡眠时督促取侧卧位。对ＳＡＳ患者进行健康教育也是减少危险因素的重要护理措施。

Objectives: To explore the nocturnal changes in sleeprespiratory variables in patients with obstructive sleep apnea(OSA) and the efficacy of nursing interventions in the comprehensive management of OSA. Methods: Sixteen OSA patients were evaluated for 3 separate nights:night 1 involved a diagnostic polysomnography(PSG) study; and a further evaluation of the PSG recordings at three different time periods;sleep position training was carried out on night 2; the patients were put on CPAP treatment on night 3.PSG study was repeated on night 2 and 3 respectively. Results: Apneahypopnea index increased progressively from time period 1(27.919.5) to time period 2(46.421.1,P<0.05) and time period 3(65.518. 2, P < 0. 01) . Oxygen saturation nadir also decreased significantly in time period 2 and 3 compared with time period 1.Both sleep position training and CPAP treatment resulted in a significant improvement in sleep apnea severity;With the treatment of CPAP,a significant improvement in sleep structure was also found. Conclusions: The severity of sleep apnea might get worse progressively throughout the night and special attention should be paid to the later half of the night.OSA management involved multiple disciplines,among which nursing intervention was an important part and should not be neglected.