改良悬雍垂腭咽成形术对OSAHS患者睡眠及认知功能的影响  

Effects of modified uvulopalatopharyngoplasty on sleep and cognitive function in patients with OSAHS

作　　者：程蕾蕾 徐艳红[1] CHENG Lei-lei;XU Yan-hong(Department of Otolaryngology,Head and Neck Surgery,Ya′an People′s Hospital,Sichuan Province,Ya′an 625000,China)

机构地区：[1]四川省雅安市人民医院耳鼻咽喉头颈外科,四川雅安625000

出　　处：《河北医科大学学报》2024年第7期766-770,共5页Journal of Hebei Medical University

基　　金：四川省医学(青年创新)科研课题项目(s20049)。

摘　　要：目的 探讨改良悬雍垂腭咽成形术(modified uvulopalatopharyngoplasty, H-UPPP)治疗阻塞性睡眠呼吸暂停低通气综合征(obstructive sleep apnea hypopnea syndrome, OSAHS)患者的效果,观察睡眠情况及认知功能的变化。方法 将OSAHS患者118例纳入研究,依据不同治疗方法分为观察组与对照组,每组59例。对照组采用行为治疗,包括控制体重、戒烟戒酒、夜间侧卧等,观察组行H-UPPP治疗。治疗6个月后观察2组临床疗效,比较2组治疗前及治疗后6个月睡眠情况[呼吸暂停低通气指数(apnea hypopnea index, AHI)、最低血氧饱和度(lowest oxygen saturation, LSaO_(2))、鼾声指数(snore index, SI)、Ep-worth嗜睡量表(Ep-worth sleepiness scale, ESS)评分]和认知功能[Rey-Osterrieth复杂图形测试(complex figure test, CFT)评分、简易智能精神状态检查量表(mini-mental state examination, MMSE)评分、蒙特利尔认知评估表(Montreal cognitive assessment, MoCA)评分、事件相关电位P300]。结果 观察组治疗效果优于对照组(P<0.05)。治疗后6个月,观察组与对照组AHI、SI、ESS评分、P300潜伏期均低于治疗前,LSaO_(2)、CFT、MMSE、MoCA评分、P300波幅高于治疗前(P<0.05),且观察组AHI、SI、ESS评分、P300潜伏期低于对照组,LSaO_(2)、CFT、MMSE、MoCA评分、P300波幅高于对照组(P<0.05)。结论 H-UPPP治疗OSAHS患者具有较好的效果,能够显著减轻临床症状,改善认知障碍程度,具有临床应用价值。Objective To explore the effect of modified uvulopalatopharyngoplasty(H-UPPP)in the treatment of obstructive sleep apnea hypopnea syndrome(OSAHS),and to observe the changes of sleep and cognitive function.Methods A total of 118 patients with OSAHS were included in the study and divided into observation group(n=59)and control group(n=59)according to different treatment methods.The control group received behavioral treatment,including weight control,quitting smoking and drinking,keeping a lateral position during nighttime sleep,and the observation group received H-UPPP treatment.The clinical efficacy of the two groups was observed at 6 months after treatment,and the sleep conditions[apnea hypopnea index(AHI),lowest oxygen saturation(LSaO_(2)),snore index(SI),Ep-worth sleepiness scale(ESS)score]and cognitive function[Rey-Osterrieth complex figure test(CFT)score,mini-mental state examination(MMSE)score,Montreal cognitive assessment(MoCA)score,event-related potential P300]of the two groups were compared before and at 6 months after treatment.Results The therapeutic effect of observation group was better than that of control group(P<0.05).At 6 months after treatment,AHI,SI,ESS scores and P300 latency of observation group and control group were lower than those before treatment,while LSaO_(2),CFT,MMSE,MoCA scores and P300 amplitude were higher than those before treatment(P<0.05).AHI,SI,ESS scores and P300 latency were lower in the observation group than in the control group,whereas LSaO_(2),CFT,MMSE,MoCA score and P300 amplitude of observation group were higher than those of control group(P<0.05).Conclusion H-UPPP has a good effect in the treatment of OSAHS patients,which can significantly ameliorate clinical symptoms,improve the degree of cognitive impairment,and has application value in clincial practice.

关 键 词：阻塞性睡眠呼吸暂停 改良悬雍垂腭咽成形术 睡眠 认知 

分 类 号：R563.8[医药卫生—呼吸系统]