高压氧综合治疗对严重睡眠呼吸暂停低通气综合征患者睡眠质量的影响

Effects of hyperbaric oxygen on the sleep quality of the patients with severe sleep apnea-hypopnea syndrome

目的探讨高压氧(HBO)对严重睡眠呼吸暂停低通气综合征(SAHS)患者睡眠质量的影响。方法选择2016年1月至2018年12月在商丘市第一人民医院呼吸科诊治的SAHS患者120例,按随机数字表法分为观察组和对照组,每组60例。对照组给予经鼻持续气道正压通气治疗,观察组在对照组治疗的基础上给予HBO治疗。治疗1个月后,观察2组患者睡眠呼吸暂停低通气指数(SAHI)、动脉血氧饱和度(SaO2)、动脉血氧分压(PaO2)、动脉血二氧化碳分压(PaCO2)、最长睡眠呼吸暂停时间、呼吸暂停指数、匹兹堡睡眠质量指数量表(PSQI)评分和爱泼沃斯嗜睡程度量表(ESS)评分。结果治疗3个疗程后,与本组治疗前比较,2组患者PaO2、SaO2明显升高,PaCO2明显降低,且观察组较对照组治疗后PaO2、SaO2明显升高,PaCO2明显降低,差异均有统计学意义(P<0.05或P<0.01)。与本组治疗前比较,2组患者PSQI和ESS评分均明显降低,且观察组患者较对照组治疗后PSQI和ESS评分明显降低,差异有统计学意义(P<0.05或P<0.01)。与本组治疗前比较,2组患者SAHI、最长睡眠呼吸暂停时间、呼吸暂停指数均明显降低,且观察组治疗后明显低于对照组治疗后,差异有统计学意义(P<0.05或P<0.01)。结论HBO综合治疗严重SAHS患者的效果较好,可以有效改善夜间睡眠情况,改善呼吸紊乱功能,提高睡眠质量。

Objective To investigate the effects of hyperbaric oxygen (HBO) on the sleep quality of the patients with severe sleep apnea-hypopnea syndrome(SAHS). Methods One hundred and twenty patients with sleep apnea-hypopnea syndrome treated in our hospital from January 2016 to December 2018 were enrolled for the study and were randomly divided into the observation group and the control group, each consisting of 60 patients. The control group was treated with nasal continuous positive airway pressure ventilation, while the observation group was treated with HBO, in addition to the treatment as received by the control group. One month after treatment, the scores of sleep apnea hypoventilation index (SAHI), SaO2, PaO2, PaCO2, the duration of sleep apnea, the index of apnea, Pittsburg sleep quality index (PSQI), as well as ESS were closely observed and compared between the patients of the 2 groups. Results Following 3 courses of treatment, as compared with the indexes before treatment in the same group, the scores of PaO2 and SaO2 were significantly elevated, while the scores of PaCO2 were considerably reduced. The PaO2, SaO2 scores of the observation group were obviously elevated and PaCO2 scores were markedly reduced, as compared with those of the control group, and statistical significance could be seen when comparisons were made between the 2 groups (P<0.05 or (P<0.01). Also as compared with the indexes before treatment in the same group, the PSQI and ESS scores of the 2 groups were all significantly reduced, and the scores of the observation group were decreased more markedly as compared with those of the control group, also with statistical significance (P<0.05 or (P<0.01). Compared with the scores before treatment in the same group, the SAHI, the duration of apnea and apnea scores of the 2 groups were all decreased significantly, and the scores of the observation group after treatment were significantly lower than those of the control group after treatment, also with statistical significance (P<0.05 or (P<0.01). Conclusion HBO could produce better therapeutic effects in the treatment of severe SAHS, effectively improve night sleep, respiratory disorders and sleep quality as well.