阻塞性睡眠呼吸暂停低通气综合征伴鼻阻患者经单纯鼻部手术治疗疗效观察

Curative effect of simple nasal surgery on obstructive sleep apnea hypopnea syndrome with nasal obstruction

目的探究单纯鼻部手术对阻塞性睡眠呼吸暂停低通气综合征(OSAHS)伴鼻阻患者睡眠的影响。方法选取2016年3月-2017年3月于该院行单纯鼻部手术治疗的OSAHS伴鼻阻患者60例作为研究对象。均进行多导睡眠监测和Epworth嗜睡程度评分(ESS),采用配对t检验对患者术前、术后3个月睡眠结构、睡眠质量、体位及紊乱性睡眠呼吸(SDB)情况进行比较。结果单纯鼻部术后患者快速动眼睡眠(REM)期较术前延长,N1期较术前缩短,差异有统计学意义(P <0.05),N2和N3、N4期与术前相比无明显变化,差异无统计学意义(P>0.05)。单纯鼻部手术增加患者夜间休息时间(TIB)、夜间睡眠时间(TST)和睡眠效率(SE),降低觉醒指数(ArI)和日间嗜睡得分(ESS),以上参数与术前相比差异均有统计学意义(P <0.05)。术后患者夜间鼾声时间所占比例低于手术前,差异有统计学意义(P <0.05),术后呼吸暂停低通气指数(AHI)、最低血氧饱和度(LSaO_2)及夜间体位较术前差异无统计学意义(P>0.05)。结论单纯鼻部手术可改善患者睡眠结构和睡眠质量,减少夜间打鼾,对睡眠体位、呼吸暂停和低通气无改善作用。

【Objective】To investigate the effect of simple nose surgery on sleep in patients with obstructive sleep apnea hypopnea syndrome(OSAHS) with nasal obstruction.【Methods】Sixty patients with OSAHS and nasal obstruction treated with simple nose surgery in our hospital from March 2016 to March 2017 were selected as the research subjects. Polysomnography and Epworth sleepiness scale(ESS) score were carried on all patients. The sleep structure, sleep quality, posture and sleepdisordered breathing(SDB) of patients before the operation and 3 months after the operation were compared using paired t test. 【Results】The rapid eye movement(REM) stage of the patients after simple nose surgery was longer than that before operation, and the N1 phase was shorter than that before operation, and the difference was statistically significant(P <0.05). There were no obvious changes in N2, N3 and the fourth stage compared with those before operation and the difference was not statistically significant(P >0.05). Simple nose surgery improved the patients’ time in bed(TIB), total sleep time(TST) and sleep efficiency(SE), and reduced arousal index(ArI) and daytime sleepiness score(ESS), there were significant differences in the above parameters before and after treatment(P <0.05). The rate of snoring at night was lower than that before operation, and the difference was statistically significant(P <0.05). The postoperative apnea hypopnea index(AHI), lowest oxygen saturation(LSaO2) and nocturnal position of the patients were not significantly different from those before surgery(P >0.05).【Conclusion】Simple nose surgery can improve sleep structure and sleep quality and reduce snoring at night, which has no effect on sleeping posture, apnea and hypoventilation.