经鼻持续气道正压通气治疗睡眠呼吸暂停综合征的依从性及其影响因素

The compliance with nasal continuous positive airway pressure in patients with sleep apnea syndrome

目的 调查睡眠呼吸暂停综合征 (SAS)患者接受经鼻持续气道正压通气 (nCPAP)治疗的依从性、主观疗效和不良反应 ,了解影响依从性的相关因素。方法 对我院 1994年 2月～ 2 0 0 0年 8月间接受nCPAP治疗的 118例SAS患者进行有关依从性的问卷调查并分析其影响因素。结果 118例SAS患者中 5 7%应用nCPAP依从性良好 ,影响nCPAP治疗依从性的因素主要有治疗前睡眠呼吸暂停 /低通气指数 (AHI) (P =0 0 35 )、治疗前夜间最低血氧饱和度 (LSaO2 ) (P =0 0 0 6 )、治疗前及后Epworth嗜睡评分 (ESS) (P值均 <0 0 0 1)及CPAP呼吸机的性能 (P <0 0 0 1)。结论 5 7%的SAS患者能长期坚持应用nCPAP治疗 ,nCPAP可作为SAS长期治疗的重要手段 ;影响nCPAP治疗依从性的因素主要有治疗前AHI、治疗前夜间LSaO2 、治疗前及后ESS及CPAP呼吸机的性能。

Objective To investigate the compliance with nasal continuous positive airway pressure (nCPAP) therapy in patients with sleep apnea syndrome (SAS) and to analyze the factors influencing the compliance Methods A questionnaire about compliance was sent to 118 patients with SAS who accepted nCPAP home therapy from Feb, 1994 to Aug, 2000 The factors influencing compliance were analyzed Results The compliance rate of nCPAP was 57% The major factors influencing compliance were apnea hypopnea index (AHI, P =0 035), the lowest oxygen saturation (LSaO 2) during sleep ( P =0 006), Epworth sleepiness scale (ESS) before and after treatment ( P <0 001) and the quality of nCPAP ventilators ( P <0 001) Conclusions (1) The self reported compliance with nCPAP treatment is good (2) The factors influencing compliance are AHI, LSaO 2 during sleep before treatment, ESS before and after treatment, and the quality of nCPAP ventilators