经鼻高流量湿化氧疗与持续气道正压通气治疗阻塞型睡眠呼吸暂停综合征患者的效果比较

Comparison of effects of high-flow nasal cannula oxygen therapy and continuous positive airway pressure ventilation in treatment of patients with obstructive sleep apnea syndrome

目的:比较经鼻高流量湿化氧疗(HFNC)与持续气道正压通气(CPAP)治疗阻塞型睡眠呼吸暂停综合征(OSAS)患者的效果。方法:选取2020年1月至2022年8月该院收治的60例OSAS患者进行前瞻性研究,按随机数字表法将其分为对照组(n=30)与观察组(n=30)。对照组给予CPAP治疗,观察组给予HFNC治疗。比较两组临床疗效,治疗前后睡眠结构指标[呼吸暂停低通气指数(AHI)、觉醒指数(AI)、总睡眠时间(TST)、睡眠有效率(SE)]水平、鼻腔功能指标[鼻腔最小横截面积(NMCA)、鼻腔最小横截面至前鼻孔距离(DCAN)、鼻腔容积(NCV)]水平、主观症状[Epworth嗜睡量表(ESS)]评分,以及不良反应发生率。结果:观察组治疗总有效率为86.67%,高于对照组的63.33%,差异有统计学意义(P<0.05);两组AHI、AI水平均低于治疗前,且观察组低于对照组,两组TST、SE水平均高于治疗前,且观察组高于对照组,差异有统计学意义(P<0.05);治疗前后,两组NMCA、DCAN水平比较,差异均无统计学意义(P>0.05);治疗后,观察组NCV水平高于对照组,差异有统计学意义(P<0.05);两组ESS评分均低于治疗前,且观察组低于对照组,差异有统计学意义(P<0.05);两组不良反应发生率比较,差异无统计学意义(P>0.05)。结论:HFNC治疗OSAS患者可提高治疗总有效率和鼻腔容积,改善睡眠结构指标水平,降低主观症状评分,其效果优于CPAP治疗。

Objective:To compare effects of high-flow nasal cannula oxygen therapy(HFNC)and continuous positive airway pressure(CPAP)in treatment of patients with obstructive sleep apnea syndrome(OSAS).Methods:A prospective study was conducted on 60 patients with OSAS admitted to the hospital from January 2020 to August 2022.They were divided into control group(n=30)and observation group(n=30)by using the random number method.The control group was treated with CPAP,while the observation group was treated with HFNC.The clinical efficacy,the sleep structure index[apnea hypopnea index(AHI),arousal index(AI),total sleep time(TST),sleep efficiency(SE)]levels,the nasal function index[nasal minimum cross-sectional area(NMCA),nasal minimum cross-sectional area to anterior nostril distance(DCAN),the nasal cavity volume(NCV)]levels,and the subjective symptoms[Epworth sleepiness scale(ESS)]score before and after the treatment,and the incidence of adverse reactions were compared between the two groups.Results:The total effective rate of the observation group was 86.67%,which was higher than 63.33%of the control group,and the difference was statistically significant(P<0.05).The levels of AHI and AI in the two groups were lower than those before the treatment,and those in the observation group were lower than those in the control group;the levels of TST and SE in the two groups were higher than those before the treatment,and those in the observation group were higher than those in the control group;and the differences were statistically significant(P<0.05).Before and after the treatment,there were no significant differences in the levels of NMCA and DCAN between the two groups(P>0.05).After the treatment,the level of NCV in the observation group was higher than that in the control group,and the difference was statistically significant(P<0.05).The ESS scores of the two groups were lower than those before the treatment,that in the observation group was lower than that in the control group,and the differences were statistically significant(P<0.05);there was no significant difference in the incidence of adverse reactions between the two groups(P>0.05).Conclusions:HFNC in the treatment of the OSAS patients can improve the total effective rate of treatment and the nasal cavity volume,improve the levels of sleep structure indexes,and reduce the subjective symptom scores.Moreover,it is superior to CPAP treatment.