不同压力滴定技术对重度阻塞性睡眠呼吸暂停低通气综合征患者正压通气效果的影响

Influence of different methods of CPAP pressure titration on effect of serious obstructive sleep apnea hypopnea syndrome treated with continuous positive airway pressure

目的探讨不同压力滴定技术对重度阻塞性睡眠呼吸暂停低通气综合征(obstructive sleep apnea hypopnea syndrome,OSAHS)患者使用经鼻持续气道正压通气(continuous positive airway pressure,CPAP)治疗效果的影响。方法将60例愿意接受CPAP治疗的重度OSAHS患者随机分为实验组和对照组各30例,实验组使用标准实验室手工压力滴定技术;对照组使用自动压力滴定技术。所有患者压力滴定前均进行CPAP治疗相关知识教育。两组接受CPAP治疗前和治疗后6个月进行SAQLI生活质量量表评分及嗜睡评分,并对比呼吸机使用情况及多导睡眠图(polysomnography,PSG)各项参数。结果实验组生活质量改善程度明显高于对照组;实验组呼吸机使用天数、平均每天使用时间、呼吸暂停低通气指数(AHI)、最低血氧饱和度(LSAT)、﹤90%的氧减时间等各项参数较对照组明显改善(P<0.05)。结论标准实验室手工压力滴定技术可以显著提高重度阻塞性睡眠呼吸暂停低通气综合征患者持续气道正压通气治疗效果。

Objective To research the influence of different methods of CPAP pressure titration for treatment effect of obstructive sleep apnea hypopnea syndrome （OSAHS） patients treated with nasal continuous positive airway pressure （CPAP）. Methods Divided 60 OSAHS patients treated with CPAP into experimental group and control group. Both groups have 30 patients. The patients in experimental group were carried on standards laboratory manual pressure titration, while the patients in control group were carried on automatic pressure titration. Before pressure titration, all OSAHS patients and their families were educated for the knowledge of CPAP treatment. All patients filled in SAQLI scale and Epworth sleepiness scale, and we compared status of using breathing machine and PSG parameters before and after 6 months treatment. Results The improvement on quality of life of experimental group was higher than the control group. The average total days, average actual using hours every day, apnea hypopnea index, lowest oxygen saturation, the percentage of recording time with oxygen saturation of 90% or less in experimental group were better than the control group. Conclusion The standards laboratory manual pressure titration could significantly improve the treatment effect of serious obstructive sleep apnea hypopnea syndrome treated with continuous positive airway pressure.