持续气道正压通气治疗阻塞性睡眠呼吸暂停综合征疗效观察

Effects of nasal continuous positive airway pressure in treatment of obstructive sleep apnea syndrome

目的:探讨经鼻持续气道正压通气(nCPAP)治疗阻塞性睡眠呼吸暂停综合征(OSAS)的疗效。方法:选取在我院经多导睡眠图(PSG)确诊OSAS患者52例,经3个月nCPAP治疗后,观察其PSG指标、临床症状、Epworth嗜睡量表(ESS)、SAS量表及SDS量表评分的变化。结果:治疗后呼吸暂停低通气指数(AHI)(3.2±1.4 vs 52.6±11.3)n/h,血氧饱和度<90%,睡眠时间占总睡眠时间(TSaO2<90%)(1.7±0.9 vs 35.4±8.6)%,Ⅰ+Ⅱ期睡眠时间占总睡眠时间(71.8±7.4 vs 83.9±4.6)%较前减少;夜间最低血氧饱和度(MinSaO2)(89.4±6.5 vs 70.8±9.1)%,平均血氧饱和度(MeanSaO2)(95.2±5.1 vs 90.7±6.3)%,Ⅲ+Ⅳ期睡眠时间占总睡眠时间较前增加(15.2±6.3vs 5.6±2.4)%;夜间打鼾等临床症状较前缓解;ESS评分(6.3±2.7 vs 13.8±4.2)分,SAS评分(46.82±3.42 vs 57.87±4.23)分,SDS评分(46.83±3.16 vs 61.14±5.33)分较前降低;治疗前后变化差异有显著性(P<0.01)。结论:nCPAP治疗能改善OSAS患者睡眠呼吸功能、临床症状及心理状况,是治疗OSAS的有效方法。

To evaluate the effect of nasal continuous positive airway pressure （nCPAP） in the treatment of obstructive sleep apnea syndrome （OSAS）.Methods：52 patients with OSAS diagnosed by polysomnography （PSG） in our hospital were selected and treated by nCPAP.The changes of PSG indexes, clinical symptoms, Epworth Sleepiness Scale （ESS）, SAS scale and the SDS scale scores were observed after 3 months of nCPAP treatment.Results：After nCPAP treatment,apnea-hypopnea index （AHI） [（3.2±1.4） n/h vs.（52.6±ll.3）n/h],the ratio of the time during SAO2〈90% to the total sleep time （TSaO2〈90）（1.7±0.9 vs.35.4＋ 8.6）% and the ratio of the time during stage I ＋ II sleep to the total sleep time was decreased [（71.8±7.4） % vs. （83.9±4.6） %]; minimum oxygen saturation in night （MinSaO2） [（89.4±6.5）% vs.（70.8±9.1） %], mean oxygen saturation （meanSaO2）[（95.2±5.1） % vs.（90.7±6.3）%] and the ratio of the time during stage Ill＋IV sleep to the total sleep time was increased by （15.2±6.3 vs. 5.6±2.4）; clinical symptoms such as snoring were im- proved; ESS scores （6.3±2.7 vs. 13.8±4.2 ）,SAS scores （46.82±3.42 vs. 57.87 ±4.23） and SDS scores （46.83±3.16 vs. 61.14±5.33） were reduced ;the difference between before and after nCPAP treatment was significant （P〈0.01）.Conclusion：nCPAP treatment can improve the sleep respiratory function,clinical symptoms and psychological status of the patients with OSAS,which is an effective treatment method for OSAS.