麻醉睡眠平衡术治疗慢性失眠症的疗效评估  

Evaluation of the therapeutic effect of anesthetic sleeping balance for treatment of chronic insomnia

作　　者：蒋晓江[1] 陈向阳[1] 葛衡江[2] 姚国恩[1] 李训军[1] 闫红[2] 胡银[1] 张园[1] 

机构地区：[1]第三军医大学大坪医院野战外科研究所脑三科,重庆400042 [2]第三军医大学大坪医院野战外科研究所麻醉科,重庆400042

出　　处：《中华神经医学杂志》2009年第2期174-176,180,共4页Chinese Journal of Neuromedicine

摘　　要：目的评价麻醉睡眠平衡术治疗慢性失眠症的疗效。方法选择第三军医大学大坪医院野战外科研究所脑三科收治的24例慢性失眠症患者，在患者自愿并征得书面同意后给予麻醉睡眠平衡术治疗。采用多导睡眠监测系统及里兹睡眠评估问卷（LSEQ）对患者治疗前后睡眠情况进行评估。结果患者经麻醉睡眠平衡术治疗后LSEQ得分增加100分以上患者22例，有效率为22／24（92％）。患者在入睡情况、睡眠质量、警觉行为和总分等方面均较治疗前有明显改善，差异均有统计学意义（P〈0．05）。多导睡眠监测结果表明：治疗后患者睡眠进程中的总睡眠时间有所延长，而觉醒次数明显减少，相应的觉醒时间也明显缩短，与治疗前比较，差异均有统计学意义（氏0．05），但睡眠潜伏期无明显变化；睡眠结构中的S1期睡眠较治疗前明显减少，S3期、S4期及REM期睡眠则明显增加，差异均有统计学意34（P〈0．05），而S2期睡眠却未见明显变化。结论麻醉睡眠平衡术是短时间内纠正慢性失眠患者睡眠债务行之有效的方法，对部分难治性慢性失眠患者睡眠结构的改善亦有良好的效果。Objective To evaluate the effect of anesthetic sleeping balance for treatment of chronic insomnia. Methods Twenty-four patients with chronic insomnia were treated with anesthetic sleeping balance on a voluntary basis with written informed consent. Polysomnographic （PSG） recordings were conducted and the scores of Leeds Sleep Evaluation Questionnaire （LSEQ） were measured before and after the therapy. Results Twenty-two of these patients showed an increase in the LSEQ score of over 100 after the therapy, with a total response rate of 92%. The therapy resulted in significant improvements in the sleep latency, sleep quality, alertness and behavioral integrity on the following morning and the total scores （P〈0.05）. PSG recording suggested increased total sleep duration, decreased sleep interruption frequency and shortened duration of wakefulness after the therapy, showing significant differences from the status before the therapy （P〈0.05）. Significant favorable changes also occurred in sleep architecture after the therapy, manifested by decreased S1% and increased S3%, S4% and percentage of rapid eye movement time. Conclusion Anesthetic sleeping balance may help minimize the sleep debt in patients with chronic insomnia and has also good effect in improving the sleep architecture in patients with refractory chronic insomnia.

关 键 词：麻醉睡眠平衡术 慢性失眠症 异丙酚 多导睡眠监测 里兹睡眠评估问卷 

分 类 号：R686[医药卫生—骨科学]