经鼻持续正压通气治疗阻塞性睡眠呼吸暂停综合征的临床效果

Clinical effect of nasal continuous positive airway pressure on obstructive sleep apnea syndrome

目的观察经鼻持续正压通气治疗对阻塞性睡眠呼吸暂停综合征患者的治疗效果及对患者心肌缺血的影响。方法将78例阻塞性睡眠呼吸暂停综合征患者随机分为两组,对照组患者采用常规药物治疗+面罩吸氧治疗,观察组患者采用常规药物治疗+经鼻持续正压通气治疗。比较两组患者治疗前后睡眠、呼吸紊乱及心肌缺血的改善情况。结果观察组治疗后睡眠时间、醒觉时间、呼吸紊乱次数(RDN)、呼吸紊乱指数(RDI)、呼吸暂停次数(OA)、窒息指数(AI)显著优于对照组(P<0.05);ST段下移发生率显著低于对照组(P<0.05)。两组治疗后心肌缺血总负荷显著低于治疗前,且观察组改善效果更显著(P<0.05)。结论采用经鼻持续正压通气治疗阻塞性睡眠呼吸暂停综合征,可显著改善患者睡眠结构,改善呼吸紊乱,也可预防心肌缺血的方式,减轻心肌缺血总负荷。

Objective To observe the clinical effect of nasal continuous positive airway pressure on obslruclive sleep apnea syndrome and myocardial ischemia. Methods Sevenly-eighl palienls with obslruclive sleep apnea syndrome were randomly divided into lwo groups, lhe control group was used conventional drug therapy ＋ mask oxygen therapy, while lhe observation group was used conventional drug treatment and nasal continuous positive airway pressure treatment. The improvement of sleep, breathing disorder and myocardial ischemia in lhe lwo groups before and after lhe treatment were observed. Results The sleep lime, awakening lime, number of respiratory disorders （ RDN）, respiratory disturbance index （ RDI）, number of apnea （ OA）, asphyxia index （ AI） of lhe observation group after treatment were significantly belter than those in lhe control group （ P〈0.05）; lhe incidence rale of ST segment depression of lhe observation group was significantly lower than lhal in lhe control group （ P〈0.05）. After treatment, lhe lolal load of myocardial ischemia in lhe lwo groups was significantly lower than lhal before treatment, lhe observation group was more significant （ P 〈0.05）. Conclusion In lhe treatment of obslruclive sleep apnea syndrome, nasal continuous positive airway pressure can significantly improve lhe sleep structure, respiratory distress, and prevent myocardial ischemia, reduce lhe lolal burden of myocardial ischemia.