自动持续气道正压通气结合压力预测治疗OSAHS的临床应用  

Application of auto-continuous positive airway pressure combined with pressure prediction in treatment of obstructive sleep apnea hypopnea syndrome

作　　者：孙楷[1] 聂洪玉[1] 刘泳[1] 徐东兰[1] 

机构地区：[1]自贡市第四人民医院呼吸与危重症医学科,四川自贡643000

出　　处：《西部医学》2016年第4期501-504,共4页Medical Journal of West China

基　　金：四川省自贡市重点科技计划项目(2013ZC22)

摘　　要：目的评估自动持续气道正压通气（auto-CPAP）结合压力预测治疗中重度阻塞性睡眠呼吸暂停低通气综合征（OSAHS）的疗效。方法连续纳入2014年10月~2015年7月通过多导睡眠图（PSG）监测得到确诊的中重度OSAHS患者59例作为研究对象,采用压力预测公式计算的压力作为auto-CPAP起始压力,对比分析治疗前后OSAHS患者睡眠呼吸紊乱和临床症状等指标的变化。结果经auto-CPAP治疗后OSHAS患者的低通气指数（AHI）、最低SpO2和平均SpO2与治疗前比较有明显的改善（P〈0.01）,III＋IV期睡眠时间及快眼动睡眠时间与治疗前比较增加（P〈0.05）,Epworth嗜睡评分与治疗前比较减少（P〈0.05）。Auto-CPAP治疗后OSHAS患者的白天嗜睡、鼾声、晨起口干、晨起头痛、夜间憋醒症状与治疗前相比都有明显改善（P〈0.05）。结论Auto-CPAP结合压力预测能改善OSAHS患者的临床症状和睡眠结构,显著减少睡眠呼吸事件,是一种安全、有效治疗OSAHS的措施。Objective To study the efficacy of auto-continuous positive airway pressure（auto-CPAP）combined with pressure prediction in the treatment of patients with moderate and severe obstructive sleep apnea hypopnea syndrome（OSAHS）.Methods 59 patients diagnosed with moderate and severe obstructive sleep apnea hyperpnoea syndrome were submitted to the study.Pressure prediction formula was used to calculate the pressure as the starting pressure of autoCPAP,and the changes of sleep-disordered breathing.The clinical symptoms in patients with OSAHS were analyzed before and after auto-CPAP treatment.Results After auto-CPAP treatment,AHI,lowest SpO2 and average SpO2 were significantly improved compared with that before treatment（P〈0.01）,the III＋IV sleep duration and rapid eye movement sleep duration were significantly increased（P〈0.05）,and Epworth sleepiness score was significantly decreased（P〈0.05）.The clinical symptoms such as excessive daytime sleepiness,snoring,dry mouth,headache,oppressive wake up were significantly improved after treatment（P〈0.05）.Conclusion Auto-CPAP combined with pressure prediction can improve the clinical symptoms and sleep structure of patients with OSAHS,and significantly reduce the sleepdisordered breathing.Auto-CPAP is a safe and effective treatment for OSAHS.

关 键 词：阻塞性睡眠呼吸暂停低通气综合征 气道正压通气 压力预测 

分 类 号：R338.63[医药卫生—人体生理学]