改良腭咽成形术对阻塞性睡眠呼吸暂停综合征患者凝血功能的影响  

Effect of modified palatopharyngoplasty on coagulation function in OSAS patients

作　　者：黄志强[1] 谢宇平[2] 何其胜[1] 惠培林[2] 王龙海[1] HUANG Zhiqiang;XIE Yuping;HE Qisheng;HUI Peilin;WANG Longhai(Dapartment of Neurology,Dazhou Municipal Hospital of Integrated Traditional Chinese and Western Medicine,Dazhou,Sichuan 635000,China;Sleep Medical Center,Gansu Provincial Peopled Hospital,Lanzhou,Gansu 730000,China)

机构地区：[1]四川省达州市中西医结合医院神经内科,635000 [2]甘肃省人民医院睡眠医学中心,兰州730000

出　　处：《重庆医学》2019年第6期953-956,共4页Chongqing medicine

基　　金：国家自然科学基金(81560228);2016年甘肃省卫生行业科研计划项目(GSWSKY2016-07);2015年甘肃省重大疾病调查研究项目(2015-01)

摘　　要：目的探讨改良腭咽成形术对阻塞性睡眠呼吸暂停综合征(OSAS)患者凝血功能的影响。方法收集2016年8月至2017年2月在甘肃省人民医院睡眠医学中心通过多导睡眠图(PSG)诊断为OSAS且符合手术指征患者58例为试验组,对照组为该院体检人员PSG排除OSAS者50例。统计两组一般资料,包括性别、年龄、BMI、高血压、2型糖尿病、吸烟史、血脂、血红蛋白、血小板计数等。检测试验组术前、手术3个月后和对照组凝血酶时间(PT)、活化部分凝血酶时间(APTT)、凝血酶时间(TT)、国际标准化比值(INR)、纤维蛋白原(Fbg)和D-二聚体(D-D)等。结果试验组BMI、血红蛋白、血小板计数、呼吸暂停低通气指数(AHI)、Fbg、D-D比对照组高,而平均血氧饱和度(SaO2)、最低SaO2、PT较对照组低,差异有统计学意义(P<0.05)。试验组术后BMI、血红蛋白、血小板计数、AHI、Fbg、D-D较术前低,而平均SaO2、最低SaO2、PT较术前高,差异有统计学意义(P<0.05)。结论 OSAS患者可能普遍存在高凝状态,而改良腭咽成形术可以通过改善OSAS缺氧状态从而逆转高凝状态。Objective To explore the effect of modified palatopharyngoplasty on the coagulation function in the patients with obstructive sleep apnea syndrome(OSAS).Methods Fifty-eight inpatients with OSAS diagnosed by the polysomnography(PSG)and conforming to the operation indication in the Sleep Medical Center of Gansu Provincial People′s Hospital from August 2016 to February 2017 were collected as the experimental group,and 50 persons undergoing the physical examination in this hospital,excluding OSAS,served as the control group.The general data in the two groups were performed the statistics,including the sex,age,BMI,hypertension,T2 DM,smoking history,blood lipids,platelet count,etc.,and PT,APTT,TT,INR,Fbg and D-D before operation and at postoperative 3 months in the experimental group and control group.Results BMI,hemoglobin,platelet count and apnea-hypopnea index(AHI),Fbg,D-D in the experimental group were higher than those in the control group,while the mean oxygen saturation(SaO2),PT and minimum(SaO2)were lower than those in the control group,the differences were statistically significant(P<0.05).The postoperative BMI,hemoglobin,platelet count,AHI,Fbg and D-D of the experimental group were lower than those before operation,while the mean SaO2,minimum SaO2 and PT were higher than those before operation,and the differences were statistically significant(P<0.05).Conclusion The high coagulation state may generally exist in the patients with OSAS,and modified palatopharyngoplasty can reverse the hypercoagulable state by improving OSAS anoxic state.

关 键 词：睡眠呼吸暂停综合征 改良腭咽成形术 凝血功能 血液凝固障碍 

分 类 号：R766.9[医药卫生—耳鼻咽喉科]