压力监测系统测定呼吸驱动力  

Assess respiratory drive by esophageal pressure measurement

作　　者：陈学军[1] 韩德民[1] 林忠辉[1] 叶京英[1] 王军[1] 林宇华[1] 

机构地区：[1]首都医科大学附属北京同仁医院耳鼻咽喉头颈外科,北京100730

出　　处：《中华耳鼻咽喉科杂志》2002年第6期405-408,共4页Chinese Journal of Otorhinolaryngology

摘　　要：目的　分析应用压力监测系统给呼吸暂停观察结果带来的改变。方法　同时进行多导睡眠监测和食管压力监测 ,比较两种方法的呼吸暂停和低通气观察结果 ,并分析造成差异的原因。结果　 3 0例阻塞性睡眠呼吸暂停综合征患者共记录到呼吸暂停和低通气 12 2 3 8次 ,其中 9 7%两种方法分型结果不同 ,最多的是混合性改为阻塞性呼吸暂停。比较两种方法对此类暂停的分型 ,从 2 6例具有此类暂停的患者记录中选两种方法都肯定的阻塞性、混合性和混合性改为阻塞性的呼吸暂停各 2次 ,呼吸驱动力恢复时间分别为 ( 4 3 0± 0 97)s、( 12 3 1± 5 3 5 )s和 ( 4 49± 1 73 )s。方差检验 ,P =0 0 2 8,三者差异显著 ;q检验结果混合性呼吸暂停与混合性改为阻塞性的呼吸暂停差异有显著性 ,说明各种探测方法对呼吸驱动力探测能力的不同可造成分型结果不同。有分型分歧的呼吸暂停次数与胸、腹导联对呼吸驱动力探测能力相关 (P =0 0 0 0 ,r2 =0 65 3 )。结论　压力监测系统的应用可提高呼吸驱动力的探测能力 ,改变呼吸暂停分型结果 。Objective To evaluate the difference between the classificatory results of esophagus pressure monitor and thorax and abdomen belt. Methods From Nov. 2000 to Jan. 2001, 34 patients received polysomnographic examination in Beijing Tongren Hospital. The aero digestive pressure was monitored simultaneously at 4 different points, ie, the distal part of esophagus , hypopharynx, oropharynx and nasopharynx. Respiratory events were classified based on measurement of thorax and abdomen movements and esophageal pressure, and two classification results were compared. Results Four patients were excluded from comparing classification results because of apnea hypopnea index <5, or deformity in face and low sleep efficiancy. Other 30 patients, 26 men and 4 women, at age of 45.4±9.5(30-66), were enrolled. Classificatory difference was found in 9.7% (1 183 out of 12 238) of the respiratory events between two methods. The largest part of apneas reclassified by esophageal pressure measurement were mixed apneas reclassified as obstructive apnea (600). The difference of respiratory drive restore time measured by two methods was found between mixed reclassified obstructive apneas and mixed apneas confirmed by two methods, P=0.028. No difference between mixed reclassified obstructive apneas and obstructive apneas confirmed by two methods. Difference of apnea classifications was due to the changes of respiratory drive restore time caused by different sensitivity of respiratory drive measurement. The number of difference was related to sensitivity of thorax and abdominal channel (P=0.000, r 2=0.653). Conclusion Apneas are easy to be misclassified due to the low sensitivity of thoracic and abdominal channel, and this problem can be solved by using esophageal pressure measurement. All kinds of apneas have anatomic and neuro-muscular factor in common.

关 键 词：压力监测系统 测定 呼吸驱动力 睡眠呼吸暂停综合征 

分 类 号：R766[医药卫生—耳鼻咽喉科]