抗反流药物联合持续气道正压通气治疗阻塞性睡眠呼吸暂停综合征伴咽喉反流的疗效分析

Analysis of the efficacy of anti-reflux drugs combined with continuous positive airway pressure ventilation in the treatment of obstructive sleep apnea syndrome with laryngopharyngeal reflux

目的探讨抗反流药物联合持续气道正压通气(CPAP)治疗阻塞性睡眠呼吸暂停综合征(OSAS)伴咽喉反流(LPR)的疗效。方法收集2020年5月~2022年5月于南京医科大学附属苏州医院和江苏大学附属人民医院耳鼻咽喉科就诊的81例男性中重度OSAS伴LPR的患者,分别予以药物(药物组)、CPAP(CPAP组)及药物+CPAP(药物+CPAP组)治疗14 d,三组均于治疗前后行多导睡眠监测(PSG),填写咽喉反流症状指数(RSI)量表和Epworth嗜睡量表(ESS)。结果三种治疗方法均可改善OSAS伴LPR的症状,其中药物+CPAP组的总有效率高于药物组和CPAP组(P<0.05)。药物组治疗14 d后RSI评分较治疗前降低,差异有统计学意义(P<0.05),ESS评分、呼吸暂停低通气指数(AHI)、最低血氧饱和度(LSaO2)较治疗前无明显改善,差异无统计学意义(P>0.05);CPAP组治疗后RSI评分无明显改善,差异无统计学意义(P>0.05),ESS评分和AHI较治疗前下降,LSaO2较治疗前提高,差异有统计学意义(P均<0.05);药物+CPAP组治疗14 d后RSI评分、ESS评分、AHI均较治疗前降低,LSaO2较治疗前提高,差异有统计学意义(P均<0.05)。结论临床上对于OSAS伴LPR患者,使用抗反流药物联合CPAP治疗能更快速控制患者症状,且治疗效果更加快速有效。

OBJECTIVE To investigate the efficacy of anti-reflux drugs combined with continuous positive airway pressure ventilation(CPAP)in the treatment of obstructive sleep apnea syndrome(OSAS)with laryngopharyngeal l reflux(LPR).METHODS A total of 81 male patients with moderate-severe OSAS and LPR who were treated at ENT department from 2020.05-2022.05 in Nanjing Medical University Affiliated Suzhou Hospital and Jiangsu University Affiliated People's Hospital were included in this study.They were treated separately with anti-reflux medication,CPAP,and anti-reflux medication combined with CPAP for 2 weeks.All three groups underwent polysomnography(PSG)monitoring and complete laryngopharyngeal reflux symptom index scale(RSI)and Epworth Sleepiness Scale(ESS)before and after treatment.RESULTS In the medication group,the RSI score decreased compared with before after 14 days treatment,and the difference was statistically significant(P<0.05),and the ESS score,AHI,and LSaO_(2)did not improve compared with that of before treatment,and the difference was not statistically significant(P<0.05).The CPAP group did not have improvement in RSI scores than before after 14 days treatment,the difference was not statistically significant(P<0.05),while ESS scores and AHI decreased and LSaO_(2)improved compared to pre-treatment,with statistically significant differences(all P<0.05).The medication+CPAP group not only had lower RSI score,ESS score,and AHI,but also had higher LSaO_(2)than before after 14 days treatment,and the difference was statistically significant(all P<0.05).CONCLUSION The combination of anti-reflux drugs with CPAP is clinically more rapid and effective in controlling the patient's symptoms in OSAS patients with LPR.