经鼻罩Auto-CPAP治疗中重度OSAHS22例疗效观察

Efficacy of nasal auto-continuous positive airway pressure in treating 22 patients with moderate and severe obstructive sleep apneahypopnea syndrome

目的评价经鼻罩自动调节持续气道正压通气呼吸机(Auto-CPAP)治疗中重度阻塞性睡眠呼吸暂停低通气综合征(OSAHS)患者的短期临床疗效。方法 22例经多导睡眠图(PSG)确诊的中重度OSAHS患者使用Auto-CPAP进行治疗2 d,观察治疗前后患者呼吸暂停/低通气指数(AHI)、最低血氧饱和度(LSaO2)、睡眠平均血氧饱和度(MSaO2)、呼吸暂停最长时间和血氧<90%的时间的变化;同时观察患者治疗后临床症状改善情况。结果治疗后,患者AHI、呼吸暂停最长时间、血氧<90%的时间均明显下降,与治疗前比较,差异有高度统计学意义(P<0.01);而治疗后LSaO2、睡眠平均SaO2均明显升高,与治疗前比较,差异有高度统计学意义(P<0.01)。22例OSAHS患者均顺利接受auto-CPAP治疗,治疗后所有患者打鼾、夜间憋醒、晨起头痛等症状均有不同程度的减轻,口干、白天嗜睡及记忆力减退等症状得到缓解,夜尿次数减少或消失,与治疗前比较,差异均有统计学意义(P<0.05、P<0.01)。结论 Auto-CPAP可明显改善中重度OSAHS患者的临床症状,可作为首选的中重度OSAHS患者内科治疗方法在临床推广应用。

Objective To explore a short-term clinical effect of auto-continuous positive airway pressure （Auto-CPAP） in treatment of patients with different degree obstructive sleep apneahypopnea syndrome （OSAHS）. Methods All 22 patients with OSAHS confirmed diagnosis through polysomnography （PSG） were treated by Auto-CPAP （2 days）, and the changes of apnea hypopnea index （AHI）, the lowest oxygen saturation （LSaOz）, mean sleep oxygen saturation （MSaO2）, the average apnea time and oxygen 〈90% time before and after treatment were compared. In addition, the improvement of clinical symptoms after treatment of all patients was also investigated. Results After treatment, the AHI, average apnea time and the oxygen 〈90% time were significantly decreased compared with those before treatment （P〈0.01）, while LSaO2 and MSaO~ were statistically improved compared with those before treatment （P〈0.01）. All the 22 patients successfully received Auto- CPAP treatment, the symptoms of snore, hold up urine from sleep, headache at morning were relieved at different degrees, dry mouth, drowsiness and forgetfulness were eased, nocturia frequency was obviously decreased or disappeared compared with before treatment （P〈0.05, P〈0.01）. Conclusion Auto-CPAP can significantly improve the clinical symptoms of patients with moderate and severe OSAHS, thus it can be served as the first choice of internal medicine for treating moderate and severe OSAHS to extensively applied in clinic.