药物诱导睡眠内镜检查的鼾症患者不同部位塌陷情况与低氧血症相关性

Correlation between different site collapse and hypoxia in snoring patients undergoing drug-induced sleep endoscopy

目的探究药物诱导睡眠内镜检查的鼾症患者不同部位塌陷情况与低氧血症相关性。方法选取2018年7—12月本院确诊的单纯鼾症鼾(simple snore,SS)22例和阻塞性睡眠呼吸暂停低通气综合征(OSAHS)患者88例作为研究对象,根据睡眠呼吸暂停低通气指数(apneahypop-neaindex,AHI)分为SS组(AHI<5)、OSAHS轻度组(5≤AHI<15)、中度组(15≤AHI<30)、重度组(30≤AHI<40),各22例;另根据不同部位塌陷情况分为软腭塌陷组87例,咽侧壁塌陷组53例,会厌塌陷组12例,舌根塌陷组10例。比较SS组、OSAHS轻度组、中度组、重度组打鼾时不同组织塌陷例数情况,观察软腭塌陷组、咽侧壁塌陷组、会厌塌陷组、舌根塌陷组最低动脉血氧饱和度(arterial oxygen saturation,SaO_(2)),分析不同部位塌陷患者打鼾时最低SaO_(2)差异间的相关性。结果打鼾越严重组总塌陷部位和人数越多:SS组总塌陷29例,轻度组总塌陷37例,中度组总塌陷43例,重度组总塌陷53例,差异有统计学意义(P<0.05)。不同部位塌陷人数越多,低氧血症越严重,软腭塌陷组、咽侧壁塌陷组、会厌塌陷组LSaO_(2)比较差异均有统计学意义(P<0.05),舌根塌陷组比较差异无统计学意义。结论塌陷部位与打鼾严重程度及低氧血症严重程度相关,塌陷部位越多,特别是软腭和咽侧壁塌陷会导致打鼾和低氧血症越严重。

Objective To investigate the relationship between different site collapse and hypoxia in snoring patients undergoing drug-induced sleep endoscopy.Methods A total of 88 patients with simple snoring(smple snore,SS)and 66 patients with obstructive sleep apnea hypopnea syndrome(OSAHS)diagnosed in our hospital from July 2018 to December 2018 were as reseach subjects and they were divided into SS group(AHI<5),OSAHS mild group(5<AHI<15),moderate group(15≤AHI<30)and severe group(30≤AHI<40)according to sleep apnea hypopnea index(apneahypop-neaindex,AHI),with 22 cases in each group.There were 87 cases in soft palatal collapse group,53 cases in pharyngeal lateral wall collapse group,12 cases in epiglottic collapse group and 10 cases in tongue root collapse group.The number of different tissue collapses in SS group,OSAHS mild group,moderate group and severe group were compared.The lowest arterial oxygen saturation(SaO_(2))was observed in soft palate collapse group,pharyngeal lateral wall collapse group,epiglottis collapse group and tongue root collapse group and analyze the correlation between the lowest SaO_(2) difference in snoring in patients with collapse in different parts.Results The more severe snoring group,the more the total collapse site and number:the total collapse number in SS group was 29,the total collapse number in mild group was 37,the total collapse number in moderate group was 43,and the total collapse number in severe group was 53,the difference was statistically significant(P<0.05).The more the number of collapses in different parts of the group,the more serious the hypoxia.There were significant differences in LSaO_(2) between the soft palatal collapse group,the pharyngeal lateral wall collapse group and the epiglottic collapse group(P<0.05).The difference between the tongue root collapse group and the tongue root collapse group was not statistically significant.Conclusion The collapse site is related to the severity of snoring and hypoxemia.The more collapse sites,especially the collapse of soft palatine and pharyngeal side wall,the more serious snoring and hypoxia.