远程管理对阻塞性睡眠呼吸暂停低通气综合征患者无创正压通气治疗依从性的影响

Effect of remote management on compliance of noninvasive positive pressure ventilation in patients with obstructive sleep apnea hypopnea syndrome

目的 探讨远程管理对阻塞性睡眠呼吸暂停低通气综合征(OSAHS)患者无创正压通气(NPPV)治疗依从性的影响。方法 选择2018年1月至2019年12月于我院诊断为OSAHS并接受NPPV治疗的111例患者作为研究对象,根据呼吸机类型将其分为远程管理组(60例)、常规读卡组(51例)。治疗开始后1、4周及3个月时对两组进行电话随访,治疗6个月来院复诊,读取呼吸机使用相关数据。比较两组的NPPV治疗依从性、Epworth嗜睡量表(ESS)评分、呼吸暂停低通气指数(AHI)、呼吸机使用时长;采用Spearman相关性分析依从性与治疗前、后所有监测数据之间的相关性。结果 远程管理组的NPPV治疗依从率高于传统读卡组,差异具有统计学意义(P<0.01)。远程管理组的ESS评分、AHI低于传统读卡组,呼吸机使用时长长于传统读卡组,差异具有统计学意义(P<0.01)。Spearman相关性分析结果显示,依从性与远程管理、治疗后ESS评分、AHI及呼吸机使用时长显著相关(P<0.01)。结论 远程管理作为一种新的随访手段,可提高OSAHS患者NPPV治疗的依从性。

Objective To explore the effect of remote management on the compliance of noninvasive positive pressure ventilation(NPPV)in patients with obstructive sleep apnea hypopnea syndrome(OSAHS).Methods A total of 111 patients diagnosed with OSAHS and treated with NPPV in our hospital from January 2018 to December 2019 were selected as the research objects.According to the type of ventilator,the patients were divided into remote management group(60 cases)and traditional card reading group(51 cases).The two groups were followed up by telephone at 1,4 weeks and 3 months after the start of treatment.After 6 months of treatment,they came to the hospital for further consultation,and the relevant data of ventilator use was read.The compliance of NPPV treatment,Epworth Sleepiness Scale(ESS)score,apnea hypopnea index(AHI)and duration of ventilator use were compared between the two groups;Spearman correlation analysis was used to analyze the correlation between compliance and all monitoring data before and after treatment.Results The NPPV treatment compliance rate of the remote management group was higher than that of the traditional card reading group,and the difference was statistically significant(P<0.01).The ESS score and AHI of the remote management group were lower than those of the traditional card reading group,the duration of ventilator use was longer than that of the traditional card reading group,and the differences were statistically significant(P<0.01).Spearman correlation analysis results showed that compliance was significantly correlated with remote management,ESS score,AHI and duration of ventilator use after treatment(P<0.01).Conclusion Remote management as a new follow-up method can improve the compliance of NPPV treatment in OSAHS patients.