持续气道正压通气和高压氧疗对阻塞性睡眠呼吸暂停低通气综合征疗效对比研究

A Comparative Study of the Effect of Continuous Positive Airway Pressure and Hyperbaric Oxygen Therapy on Obstructive Sleep Apnea Hypopne Syndrome

目的:观察持续气道正压通气(CPAP)和高压氧疗(HBOT)对不同程度的阻塞性睡眠呼吸暂停低通气综合征(OSAHS)患者的短期治疗效果。方法:选取2018年7月至2019年7月内蒙古包头市中心医院收治的OSAHS患者120例作为研究对象,按照随机数字表法分为观察组(n=62)和对照组(n=58)。每组根据睡眠呼吸暂停低通气指数(AHI)严重程度,分为轻度OSAHS组和中-重度OSAHS组,即分别为观察组的轻度OSAHS组(C1)和中-重度OSAHS组(C2)及对照组的轻度OSAHS组(H1)和中-重度OSAHS组(H2)。观察组给予CPAP治疗,对照组给予高压氧疗,2组患者均治疗4周,治疗期间观察组脱落12例,对照组脱落8例,最终入组观察组及对照组各50例,分别在治疗前、后行主观问卷评分,Epworth嗜睡量表(ESS)评定及多导睡眠监测,评估4组患者主观症状改善情况、ESS评分及AHI治疗前后的对比。结果:2组患者经过4周治疗,2组治疗前后的所有患者主观问卷评分症状,包括白天和夜间症状明显改善,差异有统计学意义(P<0.05),总有效率达88.9%,有明显差异。C1组、H1组及H2组治疗前后ESS评分比较,差异无统计学意义(P>0.05),C2组治疗前后ESS评分比较,差异有统计学意义(P<0.05)。2组患者治疗前后AHI均有降低,C1和C2组患者AHI降低分别为73.1%和79.9%;H1和H2组患者AHI降低百分比为42.0%和17.5%。AHI指数在C1、C2组及H1患者治疗前后比较,差异有统计学意义(P<0.05),而H2治疗前后比较,差异无统计学意义(P>0.05)。结论:中-重度OSAHS患者CPAP治疗优于单一高压氧疗;单一高压氧治疗对轻度OSAHS患者治疗有效,但不适用于中-重度OSAHS患者。

Objective:To observe the short-term therapeutic effect of continuous positive airway pressure ventilation(CPAP)and hyperbaric oxygen therapy(HBOT)on patients with obstructive sleep apnea-hypopnea syndrome(OSAHS).Methods:A total of 120 patients with OSAHS admitted to Baotou Central Hospital of Inner Mongolia from July 2018 to July 2019 were selected as the research objects,and were divided into observation group(n=62)and control group(n=58)according to the random number table method.Each group was divided into mild OSAHS group and moderate-severe OSAHS group according to the severity of sleep apnea hypopnea index(AHI),that is,mild OSAHS group(C1)and moderate-severe OSAHS group(C2)in the observation group and mild OSAHS group(H1)and moderate-severe OSAHS group(H2)in the control group.The observation group was treated with CPAP,and the control group was treated with HBOT.Both groups were treated for 4 weeks.During the treatment,12 cases fell off in the observation group,8 cases fell off in the control group,and 50 cases were finally enrolled in the observation group and the control group.Before and after treatment,subjective questionnaire scores,Epworth Sleepiness Scale(ESS)evaluation and polysomnography monitoring were performed to evaluate the improvement of subjective symptoms,ESS scores and the comparison of AHI before and after treatment in the four groups.Results:After 4 weeks of treatment,the subjective questionnaire scores of all patients in the two groups before and after treatment,including daytime and nighttime symptoms,were significantly improved(P s<0.05),and the total effective rate was 88.9%.There was no significant difference in ESS scores between group C1,H1 and H2 before and after treatment(P s>0.05),while there was significant difference in ESS scores between group C2 before and after treatment(P<0.05).AHI decreased in both groups before and after treatment,and the AHI decreased by 73.1%and 79.9%in C1 and C2 groups respectively.AHI decreased by 42.0%and 17.5%in H1 and H2 groups.AHI index in C1,C2 groups and H1 patients before and after treatment,the difference was statistically significant(P<0.05),while H2 before and after treatment,the difference was not statistically significant(P>0.05).Conclusion:CPAP treatment is better than simple hyperbaric oxygen therapy in patients with moderate-severe OSAHS.Hyperbaric oxygen therapy is effective in patients with mild OSAHS,but not for moderate-severe OSAHS patients.