奥美拉唑联合莫沙必利预先给药对咽喉反流合并OSAHS患者行悬雍垂腭咽成形术的影响  

Effects of pre-administration of omeprazole combined with mosapride on laryngopharyngeal reflux and uvulopalatopharyngoplasty in the patients with obstructive sleep apnea hypopnea syndrome

作　　者：王军[1] 高刚[1] 秦阳[1] 沈倪美[1] Wang Jun;Gao Gang;Qin Yang;Shen Nimei(Department of Otorhinolaryngology&Surgical Department of Head and Neck,Nantong First People′s Hospital,Nantong 226001,China)

机构地区：[1]南通市第一人民医院耳鼻咽喉头颈外科,江苏南通226001

出　　处：《海军医学杂志》2022年第10期1136-1140,共5页Journal of Navy Medicine

摘　　要：目的 探究奥美拉唑联合莫沙必利预先给药对咽喉反流(LRP)合并阻塞性睡眠呼吸暂停低通气综合征(OSAHS)患者行悬雍垂腭咽成形术的影响。方法 选取2016年10月至2021年10月南通市第一医院耳鼻喉头颈外科接诊的82例LRP合并OSAHS患者。按数字表法随机分为对照组(41例)和预先给药组(41例)。对照组术前服用艾司奥美拉唑肠溶片(20 mg/次)与枸橼酸莫沙必利片(5 mg/次),行悬雍垂腭咽成形术后继续服用8周艾司奥美拉唑肠溶片(20 mg/次,2次/d)与枸橼酸莫沙必利片(5 mg/次,3次/d)。预先给药组在术前8周开始服用艾司奥美拉唑肠溶片与枸橼酸莫沙必利片(剂量同对照组),停药后手术,术后不再服药。统计2组患者围术期及术后并发症情况、监测患者睡眠呼吸暂停低通气指数(AHI)、统计疗效评价、术后疼痛评分,并对手术前后咽喉反流情况进行评估。结果 预先给药组LRP合并OSAHS患者的手术时间短于对照组(P<0.05),出血量少于对照组(P<0.05),术后并发症发生率低于对照组(P<0.05)。术后8周,预先给药组患者AHI频率低于对照组(P<0.05)。术前8周和术后8周,2组LRP合并OSAHS患者的反流症状评分(RSI)与反流体征评分(RFS)经比较差异均无统计学意义(P>0.05);术前1 d,预先给药组患者的RSI与RFS评分低于对照组(P<0.05)。术后1 d,2组患者的视觉模拟疼痛量表(VAS)评分比较差异无统计学意义(P>0.05);术后3 d和7 d预先给药组的VAS评分低于对照组(P<0.05)。结论 LRP合并OSAHS患者行悬雍垂腭咽成形术前预先给予奥美拉唑联合莫沙必利治疗有助于缩短手术时间,减少术后并发症,并且可以有效降低术后疼痛缓解咽部疼痛,提高临床疗效。Objective To investigate the effect of omeprazole combined with mosapride on laryngopharyngeal reflux(LPR)and uvulopalatopharyngoplasty in the patients with obstructive sleep apnea hypopnea syndrome(OSAHS).Methods 82 patients with LPR complicated with OSAHS who received medical care from October 2016 to October 2021 in the hospital were recruited as research subjects,and were randomly divided into the control group(n=41) and the pre-administration group(n=41).Before surgery,the control group took esmprazole enteric coated tablets(at a dosage of 20 mg/once) and mosapride citrate tablets(5 mg/once),and continued to take esmprazole enteric coated tablets(20 mg/once,twice/a day) and mosapride citrate tablets(5 mg/once,3 times/a day) for a succession of 8 weeks after uvulopalatopharyngoplasty.The pre-administration group began to take esomeprazole enteric coated tablets and mosapride citrate tablets(with the same dosages as those of the control group) 8 weeks before operation.Surgery started following termination of drugs,and no drugs were taken any more after surgery.The perioperative and postoperative complications of the two groups were summarized,the sleep apnea hypopnea index(AHI) was monitored,the curative effects were evaluated,the postoperative pain scores and the pharyngeal reflux before and after surgery were evaluated.Results The surgical time for the patients with LRP combined with OSAHS in the pre-dministration group was shorter than that in the control group(P<0.05),the amount of bleeding was less than that in the control group(P<0.05),and the rate of postoperative complications in the former was also lower than that in the latter(P<0.05).Eight weeks after surgery,the frequency of AHI in the pre-administration group was lower than that in the control group(P<0.05).Both 8 weeks before surgery and after surgery,there were no significant differences in RSI and RFS scores of the patients with LRP combined with OSAHS,when comparisons were made between the two groups(P>0.05).One day before surgery,the RSI and

关 键 词：奥美拉唑 莫沙必利 咽喉反流 阻塞性睡眠呼吸暂停低通气综合征 外科 

分 类 号：R544.1[医药卫生—心血管疾病]