咽腔与颏舌肌锻炼对伴舒张性心功能不全腭咽成形术后遗留轻度阻塞性睡眠呼吸暂停低通气综合征患者的康复影响  

Effects of pharyngeal cavity and mentolingual muscle exercise on polysomnography,cardiac function and MACE in patients with mild OSAHS left after palatopharyngoplasty with diastolic cardiac dysfunction

作　　者：李胜[1] 肖芒[2] 姜晓华[2] 杨庆业[3] 兰金山[1] 廖红建[1] 张宏伟[1] 傅寅[1] LI Sheng;XIAO Mang;JIANG Xiaohua;YANG Qingye;LAN Jinshan;LIAO Hongjian;ZHANG Hongwei;FU Yin(Department of Otolaryngology,Quzhou People’s Hospital,Quzhou,Zhejiang,324000,China;Department of Otolaryngology Head and Neck Surgery,Sir Run Run Shaw Hospital,Zhejiang University School of Medicine,Hangzhou,Zhejiang,310000,China;Department of Cardiovascular Medicine,Quzhou People’s Hospital,Quzhou,Zhejiang,324000,China)

机构地区：[1]衢州市人民医院耳鼻咽喉科,浙江衢州324000 [2]浙江大学医学院附属邵逸夫医院耳鼻咽喉头颈外科,浙江杭州310000 [3]衢州市人民医院心血管内科,浙江衢州324000

出　　处：《中国耳鼻咽喉头颈外科》2024年第7期461-466,共6页Chinese Archives of Otolaryngology-Head and Neck Surgery

摘　　要：目的探讨咽腔与颏舌肌锻炼在伴舒张性心功能不全腭咽成形术后遗留轻度阻塞性睡眠呼吸暂停低通气综合征(OSAHS)患者中的应用效果。方法选取2021年1月~2023年8月75例伴舒张性心功能不全腭咽成形术后遗留轻度OSAHS患者进行回顾性研究,其中37例术后进行咽腔与颏舌肌锻炼(观察组),38例未进行咽腔与颏舌肌锻炼(对照组)。收集相关数据,以术后数据为基线值,对比基线及3个月后平均血氧饱和度(mean oxygen saturation,MSpO_(2))、最低血氧饱和度(lowest oxygen saturation,LSpO_(2))、睡眠效率、呼吸暂停指数(apnea index,AI)、睡眠潜伏期、呼吸暂停低通气指数(AHI)、低通气指数(hypopnea index,HI)、微觉醒指数(microarousal index,MAI)、快速眼球运动潜伏期、动脉血二氧化碳分压(PaCO_(2))、pH值、动脉血氧分压(PaO_(2))、左室收缩末期内径(left ventricular end-systolic diameter,LVDs)、血乳酸、左室射血分数(left ventricular ejection fraction,LVEF)、Tei指数、左室舒张末期内径(left ventricular end-diastolic diameter,LVDd)、日间Epworth嗜睡量表(ESS)评分、匹兹堡睡眠质量指数(PSQI)评分及不良心血管事件(major adverse cardiovascular events,MACE)的发生率。结果3个月后,观察组AHI、HI、AI低于对照组,MSpO_(2)、LSpO_(2)高于对照组(P<0.05);观察组睡眠效率高于对照组,日间ESS评分、PSQI评分、MAI低于对照组(P<0.05);观察组PaCO_(2)、LVDd、PaO_(2)、血乳酸、睡眠潜伏期、pH值、LVEF、快速眼球运动潜伏期、LVDd、Tei指数与对照组比较,无显著差异(P>0.05);观察组MACE发生率为5.41%(2/37),与对照组13.16%(5/38)相比,无显著差异(P>0.05)。结论伴舒张性心功能不全腭咽成形术后遗留轻度OSAHS患者接受咽腔与颏舌肌锻炼可改善低通气情况,缓解临床病症,提升睡眠质量,但对患者心功能改善作用有限。OBJECTIVE To investigate the effect of pharyngeal cavity and genoglossus muscle exercises in patients with mild obstructive sleep apnea syndrome(OSAHS)left over after palatopharyngoplasty with diastolic cardiac dysfunction.METHODS A total of 75 patients with mild OSAHS left after palatopharyngoplasty with diastolic cardiac dysfunction from January 2021 to August 2023 were selected for retrospective study.Among them,37 patients underwent pharyngeal cavity and mentoglossum muscle exercise(observation group),while 38 patients did not(control group).Using postoperative data as baseline value.mean blood oxygen saturation(MSpO_(2)),lowest oxygen saturation(LSpO_(2)),sleep efficiency,apnea index(AI),sleep latency,apnea hypopnea index(AHI),hypopnea index(HI),microarousal index(MAI),rapid eye movement latency,arterial blood pressure of carbon dioxide(PaCO_(2)),pH,arterial partial oxygen pressure(PaO_(2)),left ventricular end-systolic diameter(LVDs),blood lactic acid,left ventricular ejection fraction(LVEF),Tei index,left ventricular end-diastolic diameter(LVDd),daytime Epworth sleepiness scale(ESS)score,Pittsburgh sleep quality index(PSQI)score and incidence of adverse cardiovascular events(MACE)were compared at baseline and 3 months later.RESULTS After 3 months,AHI,HI and AI in observation group were lower than those in control group,and MSpO_(2)and LSpO_(2)were higher than those in control group(P<0.05);Sleep efficiency of observation group was higher than control group,daytime ESS score,PSQI score and MAI were lower than control group(P<0.05).There were no significant differences in PaCO_(2),LVDd,PaO_(2),blood lactic acid,sleep latency,pH,LVEF,rapid eye movement latency,LVDd,Tei index between the observation group and the control group(P>0.05).The incidence of MACE in the observation group was 5.41%(2/37),compared with 13.16%(5/38)in the control group,there was no significant difference(P>0.05).CONCLUSION In patients with mild OSAHS left after palatopharyngoplasty with diastolic cardiac dysfunction,the exercise of phar

关 键 词：睡眠呼吸暂停 阻塞性 舒张性心功能不全 咽腔 腭咽成形术 颏舌肌 睡眠质量 低通气 

分 类 号：R766.9[医药卫生—耳鼻咽喉科]