轻中度阻塞性睡眠呼吸暂停低通气综合征患者单纯行鼻腔扩容术疗效分析

Effect of nasal cavity ventilation expansion on mild and moderate obstructive sleep apnea syndrome

目的探讨单纯行鼻腔扩容术对轻中度阻塞性睡眠呼吸暂停低通气综合征（OSAHS）患者的疗效。方法 1应用声反射鼻腔测量（acoustic rhinometry,AR）、鼻阻力（rhinomanometer,RM）测量检测30例OSAHS患者术前、术后0~5 cm鼻腔容积（nasal cavity in 0-5cm volume,NC V0-5）、鼻腔最小横截面积（nasal minimal cross-sectional area,NMCA）、鼻气道阻力（nasal airway resistance,NAR）,鼻堵塞程度使用视觉模拟量表（visual a nalog ue scale,VAS）评分进行评价;2应用多道睡眠图（PSG）监测对30例OSAHS患者进行术前和术后3~5个月监测,使用呼吸暂停低通气指数（AHI）、最低动脉血氧饱和度（lowest Sa O2,LSa O2）进行评价,嗜睡程度使用Epworth嗜睡量表（Epworth sleepiness score,ESS）评分进行评价。结果术前NCV0-5、NMCA、NAR、VAS评分、AHI、LSa O2、ESS评分分别为（4.83±0.08）cm3、（0.37±0.03）cm2、（0.437±0.012）k Pa·s/L、7.5±1.4、（10.2±3.0）次/h,（77.3±7.2）%和11.2±2.6,与术后[（8.05±0.42）cm3、（0.58±0.04）cm2、（0.202±0.014）k Pa.s/L、4.0±1.0、（5.4±1.9）次/h,（81.3±5.9）%和7.9±1.4]比较差异有统计学意义（P均〈0.01）。结论 1鼻腔结构异常为主要阻塞平面的OSAHS患者,手术处理鼻腔阻塞平面,矫正鼻腔结构,是去除鼻腔阻塞平面治疗OSAHS的有效方法;2通过术前、术后AR、RM、PSG监测,将有助于统一规范手术适应证和术后疗效评价标准,在术前、术后评估中有助于患者治疗方案的制订,可减少不必要的手术创伤。

OBJECTIVE To investigate efficacy of nasal cavity ventilation expansion technique alone on patients with mild and moderate obstructive sleep apnea syndrome （OSAHS）. METHODS Acoustic rhinometry （AR）, rhinomanometer （RM） were used to detect nasal cavity in 0-5cm volume（NCV0-5）, nasal minimal cross- sectional area （NMCA）, nasal airway resistance （NAR） in 30 cases of mild and moderate OSAHS before and after operation. Nasal blockage degree was evaluated with visual analogue scale （VAS）. Polysomnography （PSG） was carried out in 30 cases of OSAHS before and 3-5 months after surgery. The sleep apnea and hypopnea index （AHI）, lowest arterial oxygen saturation （LSaO3）, Epworth sleepiness score （ESS） were used to evaluate the efficacy of the operation. RESULTS Preoperative NCV0-5, NMCA, NAR, VAS score, AHI, LSaO2 and ESS score were （4.83±0.08）cm3, （0.37±0.03）cm2, （0.437±0.012） kPa＇s/L, 7.5± 1.4, （10.2±3.0）/h, （77,3±7.2）% and 11.2±2.6 respectively, while the parameters after operation were （8.05 ± 0.42）cm3, （0.58 ± 0.04）cm2, （0.202 ± 0.014）kPa.s/L, 4.0 ± 1.0, （5.4± 1.9）/h, （81.3 ± 5.9）% and 7.9 ± 1.4. There were statistical significance compared with the parameters before and after operation （P〈0.01）. CONCLUSION l, Patients with OSAHS whose main obstructive level is structural abnormality of nasal cavity can be get good results through nasal cavity ventilation expansion technique. 2. The preoperative evaluation is helpful to select optimal method for management of the OSAHS patients.