电刺激舌下神经对睡眠呼吸暂停综合征的疗效观察

The observation of clinic effect of noninvasive transcutaneous electrical stimulation the branch of hypoglossal nerve in patients with obstructive sleep apnea syndrome

目的 研究经皮同步无创Lilly波形电刺激支配颏舌肌的舌下神经分支对阻塞性睡眠呼吸暂停综合征的疗效。方法 22例阻塞性睡眠呼吸暂停综合征患者给予经皮无创电刺激舌下神经分支 ,采用分夜监测的方法 ,在治疗前后分别监测多导睡眠图。结果 22例患者经治疗后显效17例 ,好转2例 ,无效3例 ,有效率77.27%。治疗后的呼吸紊乱指数(RDI)、SaO2<90%所占比例、最长呼吸暂停时间、氧减指数、最大氧减、最大氧减时间均较治疗前有明显改善(p<0.01) ,Ⅲ +Ⅳ +REM期/总睡眠时间 (TST)亦较治疗前上升(p<0.01) ,Ⅰ+Ⅱ期/TST较治疗前下降(p<0.01) ,睡眠结构改善 ,而微觉醒指数无显著性改变(p=0.07)。结论

Objective To observe the effects of noninvasive transcutaneous electrical stimulation the branch of hypoglossal nerve which domˉinates genioglossus during sleep in patients with obstructive sleep apnea syndrome(OSAS). Methods 22patients with OSAS were monitored by polysomnography during split-night with and without transcutaneous electrical stimulation the branch of hypoglossal nerve. Results 17of22patients with OSAS who accepted transcuraneous electrical stimulation had remarkable effects(reduction of RDI>50%),2of22patients were improved(reduction of RDI20%～50%).Compared with the parameters before treatment,there were many improvement in RDI、the proportion of SaO 2 <90%、the longest apnea time、the SaO 2 reduction index、the largest SaO 2 reduction、the duration of the largest SaO 2 reduction(p<0.01).I+II/TSTwas decreased and III+IV+REM/TST was increased,sleep structure improved remarkably(p<0.01).While the microarousal index had not significant difference(p=0.07). Conclusion Noninvasive transcutaneous electrical stimulation the branch of hypoglossal nerve may be an effective treatment in patients with OSAS.