多导睡眠监测仪分析不同阶段高压氧对急性脑梗死后睡眠障碍的治疗效果

Effect of hyperbaric oxygen therapy at different stages on sleep disorders after acute cerebral infarction analyzed by polysomnography

目的多导睡眠监测仪分析不同阶段高压氧对急性脑梗死后睡眠障碍的治疗效果。方法选取急性脑梗死后睡眠障碍患者120例随机均分为观察组以及对照组,均予以口服氟哌噻吨美利曲辛片常规治疗,观察组于发病0~7 d、对照组于发病8~14 d给予高压氧治疗;分别于治疗前、治疗4周时使用多导睡眠监测仪监测两组总睡眠时间(TST)、睡眠效率(SE)、第一阶段睡眠(TS1)、第二阶段睡眠(TS2)、第三阶段睡眠(TS3)、第四阶段睡眠(TS4)睡眠、快速眼动睡眠时间(REM)、觉醒期时间(WASO)、睡眠潜伏期时间(SL)及觉醒次数,评估患者睡眠状况与治疗效果;采集患者空腹静脉血检测胆碱酶活性,采用汉密尔顿抑郁量表(HAMD)评估患者负面情绪,并记录患者不良睡眠事件。结果治疗后,两组患者TST、SE、TS1、TS2、TS3、TS4、REM、WASO及SL均显著改善,且观察组均优于对照组(P<0.05);治疗4周后,两组患者的觉醒次数均较治疗前改善,且观察组患者觉醒次数低于对照组,差异有统计学意义(P<0.05);治疗后,观察组患者血液胆碱酶活性显著低于对照组(t=30.233,P<0.001);治疗后,两组患者的HAMD评分均降低,且观察组低于对照组(P<0.05);治疗后,观察组患者发生睡眠期周期性肢体运动、快动眼睡眠行为异常低于对照组(P<0.05)。结论早期给予急性脑梗死后睡眠障碍患者高压氧治疗的效果好,采用多导睡眠监测仪可监测高压氧的治疗效果。

Objective To investigate the effect of hyperbaric oxygen therapy(HBOT)at different stages on sleep disorders after acute cerebral infarction analyzed by polysomnography.Methods A total of 120 patients with sleep disorders after acute cerebral infarction were randomly divided into observation and control groups.All patients were treated with oral flupentixol and melitracen tablets.Observation group was treated with hyperbaric oxygen at 0-7 days after onset,and control group was treated with hyperbaric oxygen at 8-14 days after onset.Polysomnography was used to detect total sleep time(TST),sleep efficiency(SE),the first stage of sleep(TS1),the second stage of sleep(TS2),the third stage of sleep(TS3),the fourth stage of sleep(TS4),rapid eye movement sleep time(REM),wake after sleep onset(WASO)and sleep latency time(SL)to assess the patients'sleep status before treatment and at 4 weeks after treatment.The patients'sleep latency,TST and the times of awakenings were recorded to evaluate therapeutic effect.Fasting venous blood was collected to detect cholinesterase activity.Hamilton Depression Scale(HAMD)was used to evaluate the negative emotions of patients.Adverse sleep events were recorded.Results After treatment,TST,SE,TS1,TS2,TS3,TS4,REM,WASO,and SL in two groups were significantly improved,and they were better in observation group than in control group(P<0.05).After 4 weeks of treatment,SL,TST and the times of awakenings of two groups were improved when compared to before treatment,and SL and the times of awakenings were lower in observation group than those in control group,while TST was higher observation group than that of control group(P<0.05).After treatment,blood cholinesterase activity was significantly lower in observation group than that in control group(t=30.233,P<0.001).After treatment,HAMD was decreased in two groups.HAMD was obviously lower in observation group than that in control group(P<0.05).After treatment,periodic limb movements and abnormal rapid eye movement sleep behavior during sleep were lower in observation group than those in control group had(P<0.05).Conclusion Early administration of HBOT is effective for patients with sleep disorders after acute cerebral infarction,and polysomnography may monitor the therapeutic effect of HBOT.