经静脉膈神经刺激治疗中枢性睡眠呼吸暂停综合征的单臂Meta分析  

A Single arm Meta-analysis of transphrenic nerve stimulation for central sleep apnea syndrome

作　　者：朱鹏力 王剑 严志华 梁丹 杜叶佳 阮丹琦 ZHU PengLi;WANG Jian;YAN Zhihua;LIANG Dan;DU Yejia;RUAN Danqi(Department of Oncology,Shangyu People's Hospital,Shaoxing,Zhejiang,312300,China)

机构地区：[1]绍兴上虞人民医院肿瘤内科一放疗科,312300

出　　处：《中国老年保健医学》2024年第4期37-42,48,共7页Chinese Journal of Geriatric Care

摘　　要：目的进一步明确经静脉膈神经刺激治疗中枢性睡眠呼吸暂停综合征的有效性及安全性。方法通过计算机检索Cochrane Library、Web of Science、Embase、PubMed、中国知网、万方数据库等,根据纳入标准与排除标准筛选文献,采用RevMan 5.4软件进行Meta分析。结果本研究共纳入文献9篇,包括365例中枢性睡眠呼吸暂停综合征(CSA)患者,发现经静脉膈神经刺激在改善中枢性睡眠呼吸暂停综合征(TPNS)患者低通气指数(AHI)(MD=26.2,95%CI 24.21~28.2,P<0.001)、中枢性呼吸暂停低通气指数(CHI)(MD=23.67,95%CI 20.30~27.05,P<0.001)、氧减指数(ODI)(MD=22.99,95%CI 20.99~25.00,P<0.001)、觉醒指数(MD=16.61,95%CI 13.43~19.8,P<0.001)、Epworth嗜睡量表评分(ESS)(MD=-50.34,95%CI-60.91~-39.77,P<0.001)等方面均具有明显统计学意义。纳入的研究中1例患者出现治疗相关的心律失常、9例患者出现装置植入失败/装置相关性感染,其余未追踪到明显的TPNS相关性不良事件。结论经静脉膈神经刺激对于中枢性睡眠呼吸暂停综合征患者的睡眠参数有改善价值,且其安全性使得肯定。Objective To evaluate the efficacy and safety of transphrenic nerve stimulation in the treatment of central sleep apnea syndrome.Methods Cochrane Library,Web of Science,Embase,PubMed,CNKI,Wanfang Data and other databases were searched by computer.Literatures were screened according to inclusion and exclusion criteria,and Meta-analysis was performed using RevMan 5.4 software.Results A total of 9 literatures meeting the criteria were included,including 365 CSA patients.TPNS was found to improve AHI(MD=26.2,95%CI 24.21~28.2,P<0.001),CHI(MD=23.67,95%CI 20.30~27.05,P<0.001),ODI(MD=22.99,95%CI 20.99~25.00,P<0.001),arousal index(MD=16.61,95%CI 13.43~19.8,P<0.001),Epworth sleepiness score(MD=-50.34,95%CI-60.91~-39.77,P<0.001)were statistically significant.Among the included studies,1 patient had treatment-related arrhythmia,9 patients had device implantation failure/device-associated infection,and no significant TPNS related adverse events were traced.Conclusion Transcranial phrenic nerve stimulation can improve the sleep parameters of patients with central sleep apnea syndrome,and its safety is certain.

关 键 词：经静脉膈神经刺激 中枢性睡眠呼吸暂停综合征 有效性 安全性 

分 类 号：R766[医药卫生—耳鼻咽喉科]