鼻腔扩容术对阻塞性睡眠呼吸暂停低通气综合征患者睡眠质量的影响

Influence of nasal cavity ventilation expansion technique on sleep quality in obstructive sleep apnea hypopnea syndrome

目的 探讨鼻腔扩容术对阻塞性睡眠呼吸暂停低通气综合征（obstructive sleep apnea hypopnea syndrome,OSAHS）的影响.方法 对52例鼻阻塞的OSAHS患者采用鼻腔扩容术,术前及术后分别监测PSG和进行Epworth嗜睡量表（ESS）评分.结果 呼吸暂停低通气指数（apnea and hypopnea index,AHI）术前、术后分别为（37.52±18.00）次/h和（38.12±16.44）次/h（P=0.15）,睡眠总记录时间（453.7±32.0）min和（460.7±41.8） min（P =0.147）,总睡眠时间（368.5±35.1）min 和（360.2±46.1） min（P=0.206）,醒觉指数（Arousal index） （35.2±16.1）次/h和（14.7±11.0）次/h,（P ＜0.001）,1期睡眠时间（42.1±19.1）min和（21.7±18.1） min,（P=0.028）,2期睡眠时间（255.0±30.5） min和（186.1±46.2） min（P=0.031）,3～4期睡眠时间（21.0±16.9） min和（36.1±24.2） min（P=0.039）,快动眼睡眠时间（56.9±25.5） min和（51.5±31.5）min（P=0.071）,最低血氧饱和度（lowest oxygen saturation,LSaO2）术前、术后分别为（77.78±8.13）％和（79.74±7.11）％（P=0.063）,体质量指数（body mass index,BMI）术前、术后分别为（27.68±3.01） kg/m2和（27.96±3.52）kg/m2（P=0.43）,手术前后AHI、LSaO2、BMI差异无统计学意义；ESS评分术后下降明显,具有统计学意义（P =0.015）.结论 单纯鼻腔扩容术对OSAHS的AHI、LSaO2等客观指标无改善,但能改善睡眠质量、减轻白天嗜睡程度,仍不失为一种可选择的手术.

Objective To investigate the influence of nasal cavity ventilation expansion technique on obstructive sleep apnea hypopnea syndrome （OSAHS）.Methods Nasal cavity expansion surgery was performed in 52 OSAHS patients with rhinostegnosis.Polysomnography （PSG） testing and Epworth Sleepiness Scale （ESS） evaluation were planned before and after surgery.Results Contrast pro-to postoperation,apnea and hypopnea index （AHI） was 37.52± 18.00 versus 38.12± 16.44（P =0.15）,total recording time （453.7 ± 32.0） min versus （460.7 ± 41.8） min （P =0.147）,total sleep time （368.5± 35.1） min versus （360.2±46.1） min （P =0.206）,arousal index （35.2± 16.1） events/h versus （14.7±11.0） events/h,（P ＜0.001）,time in stage 1 NREM was （42.1±19.1） min versus （21.7± 18.1） min,（P =0.028）,time in stage 2 NREM was （255.0±30.5） min versus （186.1±46.2）min（P =0.031）,time in stage 3-4 NREM was （21.0±16.9） min versus （36.1±24.2） min （P =0.039）,time in REM sleep was （56.9±25.5） min versus （51.5±31.5） min （P =0.071）,lowest oxygen saturation （LSaO2） was （77.78 ± 8.13） ％ versus （79.74 ± 7.11） ％ （P =0.063）,body mass index （BMI） was （27.68 ± 3.01） kg/m2 versus （27.96 ± 3.52） kg/m2 （P =0.43）.These differences weren＇t statistics significance.ESS score decreased after surgery,and had statistics significance （P =0.015）.Conclusions The results suggest that single nasal cavity expansion surgery can＇t improve objective index,such as AHI,LSaO2 and BMI,but it is useful for improving sleep quality and daytime sleepiness in OSAHS with rhinostegnosis.