阻塞性睡眠呼吸暂停患者持续气道正压通气治疗依从性及影响因素的Meta分析  

Compliance and influencing factors of continuous positive airway pressure in patients with obstructive sleep apnea:a Meta-analysis

作　　者：罗英 宁莉萍 史菲菲 何梅[2] 杨卜凡 崔丽君[4] LUO Ying;NING Liping;SHI Feifei;HE Mei;YANG Bufan;CUI Lijun(School of Nursing,North Sichuan Medical College,Nanchong 637000,China;Department of Nursing Administration,Mianyang Central Hospital,Mianyang 621000,China;Department of Neurology,Mianyang Central Hospital,Mianyang 621000,China;Department of Nursing Administration,Affiliated Hospital of North Sichuan Medical College,Nanchong 637000,China)

机构地区：[1]川北医学院护理学院,四川南充637000 [2]绵阳市中心医院护理部,四川绵阳621000 [3]绵阳市中心医院神经内科,四川绵阳621000 [4]川北医学院附属医院护理部,四川南充637000

出　　处：《现代医学》2024年第9期1434-1443,共10页Modern Medical Journal

基　　金：2022年四川省卫生信息学会年度申报项目(2022054)。

摘　　要：目的:系统评价阻塞性睡眠呼吸暂停(OSA)患者持续气道正压通气(CPAP)治疗依从性及其影响因素。方法:计算机检索CNKI、万方、CBM、VIP、PubMed、Embase、Web of Science、Cochrane Library等中英文数据库中有关OSA患者CPAP治疗依从性的文献,检索时间为建库至2024年3月,使用Stata 16.0软件进行Meta分析。结果:共纳入22篇文献,累计29808例患者,其中治疗依从性好的人数为20327例。Meta分析结果显示,OSA患者CPAP治疗依从率为53.6%,年龄≥60岁(OR=1.54,95%CI 1.01~2.35)、文化水平较高(OR=1.28,95%CI 1.18~1.38)、有配偶(OR=1.46,95%CI 1.37~1.56)、使用空气加湿器(OR=1.12,95%CI 1.05~1.19)、呼吸暂停低通气指数(AHI)≥30次·h^(-1)(OR=2.06,95%CI 1.51~2.81)、白天过度嗜睡(OR=1.27,95%CI 1.19~1.36)、合并高血压(OR=1.20,95%CI 1.04~1.40)是OSA患者CPAP治疗依从性的保护因素;合并哮喘(OR=0.81,95%CI 0.66~0.98)、心理状况较差(OR=0.81,95%CI 0.68~0.95)是OSA患者CPAP治疗依从性的危险因素。结论:OSA患者CPAP治疗依从性较低,其依从性受年龄、文化水平、婚姻状况、使用空气加湿器、AHI、白天过度嗜睡、合并高血压、合并哮喘、心理状况等因素影响,医务人员开展OSA患者CPAP相关管理工作时应针对可改善因素制定个性化干预措施。Objective:To systematically evaluate the compliance of continuous positive airway pressure(CPAP)treatment in patients with obstructive sleep apnea(OSA)and its influencing factors.Methods:Papers related to the compliance of CPAP treatment in patients with OSA covered in Chinese and English databases such as CNKI,Wanfang,CBM,VIP,PubMed,Embase,Web of Science,Cochrane Library and so on were searched by computer.The retrieval time was from the establishment of the database to March 2024.Meta-analysis was performed using Stata 16.0 software.Results:A total of 22 studies were included,with a total of 29808 patients,including 20327 patients with good treatment compliance.The results of Meta-analysis showed that the compliance rate of CPAP treatment in OSA patients was 53.6%,and that age≥60 years old(OR=1.54,95%CI 1.01-2.35),higher education level(OR=1.28,95%CI 1.18-1.38),having spouse(OR=1.46,95%CI 1.37-1.56),use of air humidifier(OR=1.12,95%CI 1.05-1.19),apnea hypopnea index(AHI)≥30 times per hour(OR=2.06,95%CI 1.51-2.81),excessive daytime sleepiness(OR=1.27,95%CI 1.19-1.36)and hypertension(OR=1.20,95%CI 1.04-1.40)were protective factors for CPAP treatment compliance in OSA patients.Asthma(OR=0.81,95%CI 0.66-0.98)and poor psychological status(OR=0.81,95%CI 0.68-0.95)were risk factors for CPAP treatment compliance in OSA patients.Conclusion:The CPAP treatment compliance of OSA patients is low,which is affected by age,education level,marital status,use of air humidifier,AHI,excessive daytime sleepiness,combined with hypertension and asthma,psychological status and so on.Medical staff should formulate personalized intervention measures in accordance with the related factors when carrying out CPAP related management of OSA patients.

关 键 词：阻塞性睡眠呼吸暂停 持续气道正压通气 依从性 META分析 

分 类 号：R563[医药卫生—呼吸系统]