阻塞性睡眠呼吸暂停综合征伴阵发性室上性心动过速患者的疗效观察

Treatment of obstructive sleep apnea syndrome in patients with paroxysmal supraventricular tachycardia by nasal continuous positive airway pressure

目的:探讨经鼻腔持续正压通气联合射频消融术治疗阻塞性睡眠呼吸暂停综合征伴阵发性室上性心动过速患者的疗效。方法:回顾我院2010-01-2013-01期间收治的阻塞性睡眠呼吸暂停综合征伴阵发性室上性心动过速的患者,共44例,将其随机平均分为对照组(n=22)和实验组(n=22)。对照组给予射频消融术,而实验组在射频消融术的基础上联用经鼻腔持续正压通气治疗。术后常规随访6个月以观察具体疗效。结果:与对照组相比较,实验组患者的室上性心动过速复发率明显偏低(9.09%∶27.27%)、抗心律失常药物使用率降低(4.54%∶22.73%)、术后6月左室射血分数明显增加[(55.66±5.12)%∶(48.23±4.16%)]、术后6个月左房内径明显缩小[(34.68±3.29)mm∶(38.18±2.21mm)],上述差异均具有统计学意义(P<0.05)。结论:经鼻腔持续正压通气联合射频消融术可明显降低阻塞性睡眠呼吸暂停综合征伴阵发性室上性心动过速患者的症状复发和抗心律失常药使用量,显著改善患者的心脏结构和心脏功能,值得临床大力推广。

Objective：To investigate the efficacy of continuous positive airway pressure combined with catheter radiofrequency ablation in the treatment of obstructive sleep apnea syndrome patients with paroxysmal supravent- ricular tachycardia. Method： A total of 44 obstructive sleep apnea syndrome patients with paroxysmal supraventric- ular tachycardia were enrolled in the study from January 2010 to January 2013. The patients were randomly divided into control group （n= 22） and experimental group （n=22）. The control group received radiofrequency ablation. The experimental group received radiofrequency ablation combined with nCPAP therapy. Routine follow--up for six months was made in order to observe the specific effect. Result： Compared with the control group, the relapse rate of PSVT in the experimental group were significantly lower （9.09 % VS 27.27 % ）, and the utilization of anti- arrhythmic drug decreased （4.54% VS 22.73 %）. The LVEF increased significantly 6 months after operation（g5. 66 ± 5.12 VS 48.23 ± 4.16 % ）, the left aerial diameter significantly reduced 6 months after operation（34.68 ±3. 29 mm VS 38.18 ± 2.21 mm）, These differences were statistically significant （P〈0.05）. Conclusion： nCPAP com- bined radiofrequency ablation can significantly reduce the symptoms of OSAS patients with PSVT, reduce the use of antiarrhythmic drugs,and improve the patient＇s cardiac structure and cardiac function, This treatment was wor- thy of promoting.