影响OSAHS患者CPAP治疗依从性的因素及医院内强化护理策略  

Factors related to compliance of CPAP treatment in OSAHS patients and intensified care strategies within hospital

作　　者：励雯静[1,2,3] 邵川[4] 吴晓丹[1,2,3] 朱芬[1,2,3] 刘子龙[1,2,3] 符翠萍[1,2,3] 吴旭[1,2,3] 张舒琪[1,2,3] 白春学[1,2,3] 周新[5] 李善群[1,2,3] 

机构地区：[1]复旦大学附属中山医院呼吸科,上海200032 [2]复旦大学附属中山医院睡眠呼吸障碍与鼾症诊治中心,上海200032 [3]复旦大学呼吸病研究所,上海200032 [4]宁波市医疗中心李惠利医院呼吸科,宁波315040 [5]上海交通大学附属第一人民医院呼吸科,上海200080

出　　处：《世界临床药物》2014年第5期287-290,共4页World Clinical Drug

基　　金：上海市重点学科建设项目(编号:B115);上海市科委国际合作课题(编号:13430720500)

摘　　要：目的分析影响阻塞性睡眠呼吸暂停低通气综合征(OSAHS)患者持续正压通气(CPAP)治疗依从性的因素,探讨提高OSAHS患者CPAP治疗依从性的医院内强化护理策略。方法入选2012年2月-2012年7月在我院鼾症诊治中心和呼吸科诊断为OSAHS并接受CPAP治疗的患者49例,在CPAP呼吸机治疗第2、3 d过程中给予医院内强化护理,观察强化护理对CPAP治疗效果和患者依从性的影响。结果强化护理前后AHI参数分别为(12.28±7.92)和(5.13±4.83),平均漏气量分别为(0.62±0.45)和(0.37±0.25)L/s,平均SpO2分别为(92.57±1.61)%和(96.16±1.05)%,最低SpO2分别为(89.08±7.05)%和(95.42±3.41)%,SpO2<90%的时间比例分别为(6.48±3.45)%和(0.19±0.36)%,且所有AHI参数强化护理前后均有统计学差异(P<0.05)。医院内强化护理后出现呼吸机治疗不良反应的患者例数减少。结论医院内强化护理干预可提高OSAHS患者CPAP疗效,减少不良反应,提高患者依从性。Objective To analyze factors related to compliance of continuous positive airway pressure（CPAP） treatment in obstructive sleep apnea-hypopnea syndrome（OSAHS） patients and to explore the intensified care strategies in order to improve compliance. Methods Forty-nine patients who were diagnosed as OSAHS and given CPAP treatment in our hospital during February and July 2012 were enrolled. Intensified cares were delivered during the second and third nights of CPAP treatment and their effects on therapeutic outcomes and compliance were observed. Results AHI before and after intensified care were（12.28±7.92） and（5.13±4.83）. Average air leakage was（0.62±0.45）and（0.37±0.25）L/s. Average SpO2 were（92.57±1.61）% and（96.16±1.05）%. Lowest SpO2 were（89.08±7.05）% and（95.42±3.41）%. Percentage of time with SpO290% were（6.48±3.45）% and（0.19±0.36）%. All parameters of AHI before and after intensified care were statistically significant（P〈0.05）. Number of cases with adverse reactions of CPAP treatment decreased after intensified care. Conclusion Intensified care can enhance treatment efficacy, decrease adverse reactions and therefore improve CPAP compliance.

关 键 词：阻塞性睡眠呼吸暂停低通气综合征(OSAHS) 持续正压通气(CPAP) 依从性 强化护理 

分 类 号：R563[医药卫生—呼吸系统] R452[医药卫生—内科学]