阻塞性睡眠呼吸暂停低通气综合征与脑出血患者血肿、周围水肿和神经功能恢复的关系  

Relationship between obstructive sleep apnea-hypopnea syndrome,hematoma,encephaledema and neurological impairment recovery of patients with intracranial hemorrhage

作　　者：郑典刚 巩忠[2] 庞克军[1] 柴迎春[1] 

机构地区：[1]北京航天总医院神经外科,100076 [2]北京航天总医院神经内科,100076

出　　处：《检验医学与临床》2017年第10期1423-1425,共3页Laboratory Medicine and Clinic

摘　　要：目的探讨阻塞性睡眠呼吸暂停低通气综合征(OSAHS)与脑出血患者血肿、周围水肿和神经功能恢复的关系。方法收集108例脑出血患者,分为OSAHS组49例和对照组59例。分别于发病24h内、第8、15、30天行头颅CT检查和美国国立卫生研究院卒中量表(NIHSS)进行评分。根据CT图像计算脑血肿及血肿周围水肿体积。结果 OSAHS组发病第8天时血肿周围水肿体积和NIHSS评分水平均显著高于对照组[(56.3±22.6)mL vs.(51.0±18.7)mL,(12.0±5.4)分vs.(11.3±5.6)分],差异有统计学意义(P<0.05)。至发病第15、30天,OSAHS患者的脑血肿、周围水肿体积及NIHSS评分均显著高于对照组患者,差异有统计学意义(P<0.05)。结论合并OSAHS的脑出血患者脑血肿、周围水肿及神经功能的恢复较为缓慢,对可疑合并OSAHS的脑出血患者临床可考虑早期行无创通气治疗。Objective To explore the relationship between obstructive sleep apnea-hypopnea syndrome （OSAHS）,hematoma,encephaledema and neurological impairment recovery of patients with intracranial hemorrhage （ICH）.Methods One hundred and eight ICH patients were recruited and divided into OSAHS group （49 cases） and control group （39 cases）.All patients were given CT scan and neurological impairment evaluation （NIHSS） in 24 hours,8th day,15th day and 30th day after disease attacking.The volumes of hematoma and perihermatomal brain edema were calculated according to the CT image.Results Levels of perihermatomal brain edema volume and NIHSS scores of OSAHS group on the 8th day were significantly higher than that of control group[（56.3±22.6） vs.（51.0±18.7） mL,（12.0±5.4） vs.（11.3±5.6）].On the 15th and 30th day,perihermatomal brain edema volume,NIHSS scores and hematoma volume in the OSAHS group were significantly higher than that in the control group （P〈0.05）.Conclusion The recovery of the hematoma,encephaledema and neurological impairment in intracranial hemorrhage patients with OSAHS are slower.For these patients,early noninvasive ventilation could be considered.

关 键 词：阻塞性睡眠呼吸暂停低通气综合征 脑出血 血肿 脑水肿 神经功能缺损 

分 类 号：R766.43[医药卫生—耳鼻咽喉科]