82例睡眠呼吸暂停低通气综合征的诊断与无创正压通气治疗

Diagnosis and non-invasive positive pressure ventilation of sleep apnea hypopnea syndrome

目的探讨睡眠呼吸暂停综合征(SAHS)的诊断及自动调节持续气道内正压通气(auto-CPAP)对SAHS的治疗价值。方法82例SAHS患者,均行整夜的多导睡眠仪监测,并对18例中重度患者进行auto-CPAP治疗。结果SAHS患者随病情加重Epworth评分、呼吸紊乱程度、最长呼吸暂停时间、鼾声指数、氧减指数等参数明显增加,最低氧饱和度明显降低。Auto-CPAP治疗后呼吸紊乱和低氧血症的程度显著减轻,中枢性呼吸暂停的次数及所占时间没有明显改变。Epworth评分与呼吸紊乱、低氧血症以及打鼾的的时间和次数有明显的相关关系。结论Auto-CPAP可有效的治疗中重度SAHS患者,消除阻塞性及混合性呼吸暂停,减轻低氧血症,明显改善症状,并具有良好的接受性。夜间频繁出现的低氧血症是导致日间过度嗜睡的重要因素。

Objective To investigate the diagnosis and autotitrating continuous airway positive pressure(auto-CPAP) ventilating treatment of sleep apnea hypopnea syndrome(SAHS). Methods Eighty-two SAHS patients received all-night polysomnography(PSG), 18 moderate and severe SAHS cases undertook the auto-CPAP treatment. Results PSG parameters of moderate and severe SAHS including quantity and duration of respiratory disturbance, snoring and hypoxemia, instead of central apneas, were significantly improved after auto-CPAP rteatment.Epworth scores were significantly related with the amount and duration of hypoxemia and snoring. Conclusion Auto-CPAP can treat SAHS effectively and acceptably, eliminate obstructive and mixed apneas, abate hypoxemia and snoring,and compromised hypersomnolence is improved.