妊娠高血压合并OSAHS患者应用CPAP治疗对母儿结果的影响  

Maternal-infant outcome of patients with OSAHS &gestational hypertension treated by CPAP

作　　者：王坤[1] 张吉仲[1] 李静[1] 张庆泉[2] 张彩英[1] 钟爱明[3] 毕秀敏[1] 

机构地区：[1]荣成市人民医院耳鼻咽喉头颈外科,山东荣成264300 [2]烟台市毓璜顶医院耳鼻咽喉头颈外科 [3]荣成市人民医院妇产科

出　　处：《临床耳鼻咽喉头颈外科杂志》2017年第4期293-296,共4页Journal of Clinical Otorhinolaryngology Head And Neck Surgery

摘　　要：目的:探讨妊娠高血压合并阻塞性睡眠呼吸暂停低通气综合征(OSAHS)患者应用持续气道正压通气(CPAP)治疗对母儿结果的影响,为临床治疗提供依据。方法:选择经PSG检查确诊为OSAHS的患者117例,将能耐受坚持CPAP治疗者设为干预组(70例),未用CPAP治疗者设为对照组(47例)。对照组只接受常规药物治疗;而干预组除常规药物治疗外,同时接受CPAP治疗,并在随后的产前保健和产后过程中,记录妊娠高血压合并OSAHS孕妇的母儿结果。结果:与对照组比较,轻度、中度OSAHS孕妇中剖宫产和产后出血差异均无统计学意义(P>0.05);重度OSAHS孕妇中剖宫产、产后出血差异均有统计学意义(P<0.05或P<0.01)。与对照组比较,轻度OSAHS孕妇中新生儿窒息、胎儿生长受限、胎儿窘迫差异均无统计学意义(P>0.05);中度OSAHS孕妇中胎儿生长受限、胎儿窘迫差异有统计学意义(P<0.05);重度OSAHS孕妇中新生儿窒息、胎儿生长受限、胎儿窘迫差异均有统计学意义(P<0.05或P<0.01)。结论:妊娠高血压妇女尤其是有OSAHS高危因素者,应详细询问病史并注意是否有OSAHS的症状,一旦怀疑OSAHS,需行PSG检查。特别对于重度OSAHS的妊娠高血压患者强烈建议分娩前及早应用CPAP治疗,CPAP是一种安全有效的治疗妊娠高血压合并OSAHS的方法。Objective：To explore the clinical characteristics of obstructive sleep apnea hypopnea syndrome（OSAHS）diagnosed during pregnancy.To explore the effect on maternal and infant after treated with CPAP.Method：Data of 117 patients with OSAHS diagnosed by nocturnal blood oxygen saturation（SaO2）monitoring and PSG during pregnancy were analyzed retrospectively.All the 117 patients were voluntary and divided into intervention group[received continuous positive airway pressure（CPAP）treatment with good compliance under informed consent and conventional drug]70cases and control group（received conventional drug）47cases.Record the relevant data during the treatment about maternal and infant.Result：There was no statistical significance on the difference of cesarean delivery and postpartum hemorrhage in the pregnant women with mild OSAHS（P〉0.05）,there was no statistical significance on the difference of cesarean delivery and postpartum hemorrhage in the pregnant women with moderate OSAHS（P〉0.05）and there were statistical significance on the difference of cesarean delivery and postpartum hemorrhage in the pregnant women with severe OSAHS（P〈0.05 or P〈0.01）.There was no statistical significance on the difference of asphyxia neonatorum,fetal growth restriction and fetal distress in the pregnant women with mild OSAHS（P〈0.05）,there were statistical significance on the difference of fetal growth restriction and fetal distress in the pregnant women with moderate OSAHS（P〉0.05）,and there were statistical sig-nificance on the difference of asphyxia neonatorum,fetal growth restriction and fetal distress in the pregnant women with severe OSAHS（P〈0.05 or P〈0.01）.Conclusion：Pregnant women who have OSAHS risk factors should be paid attention to during the perinatal care and nocturnal SaO2 monitoring or PSG should be performed in the suspected OSAHS patients.Strongly advise that those serious OSAHS patients should be treated by CPAP early before delivery.CPAP was a safe and effective

关 键 词：高血压 妊娠性 睡眠呼吸暂停低通气综合征 阻塞性 持续气道正压通气 

分 类 号：R714.24[医药卫生—妇产科学]