Sanders M H, Costantino J P, Johnson J T
Department of Otolaryngology, University of Pittsburgh School of Medicine.
Chest. 1990 Apr;97(4):913-9. doi: 10.1378/chest.97.4.913.
We performed nocturnal diagnostic polysomnography (PSG 1), PSG early after UPPP on the second to the fifth postoperative night (PSG 2) and PSG late after UPPP (PSG 3) six or more weeks after surgery, on 15 male patients with obstructive sleep-disordered breathing. On PSG 1, the A + H/I for the group was 66.6 +/- 8.8 (mean +/- SE). During non-REM sleep the A + H/I on PSG 3 (29 +/- 10) was lower than it was on PSG 2 (54.3 +/- 11.3) (p = 0.004) and lower than that on PSG 1 (70.8 +/- 10.3) (p = 0.003). Similarly, during non-REM sleep, the AI on PSG 3 (16.1 +/- 7.4) was less than that on PSG 2 (39.1 +/- 10.4) (p = 0.003) and less than that on PSG 1 (41.7 +/- 9.6) (p = 0.015). In the eight patients in whom REM sleep was recorded on all three PSGs, there was no difference with respect to A + H/I or AI. The nadir of SaO2 during non-REM sleep was higher during PSG 3 than during PSG 1 (p = 0.002), but not different from that on PSG 2. There were no differences among the three studies with respect to REM-related nadirs of SaO2; however, there was a good deal of interindividual variability across the three PSGs. In general, individuals with satisfactory amelioration of sleep-disordered breathing on PSG 2 demonstrated similar improvement on PSG 3. Patients who did not have a substantial improvement in the early postoperative period often had improvement on PSG 3, but there was a good deal of interindividual variability in this regard. We conclude that PSG within a few days following UPPP is warranted in patients with obstructive sleep-disordered breathing to determine if there has been worsening of upper airway function or oxygenation (or both) during sleep in the early postoperative period. A satisfactory result early after UPPP suggests that a late postoperative PSG is unnecessary, with savings in cost and the convenience.
我们对15例患有阻塞性睡眠呼吸障碍的男性患者进行了夜间诊断性多导睡眠图检查（PSG 1），在术后第二至第五个夜晚进行了悬雍垂腭咽成形术（UPPP）后早期的多导睡眠图检查（PSG 2），以及术后六周或更长时间的UPPP后晚期的多导睡眠图检查（PSG 3）。在PSG 1中，该组的A + H/I为66.6 +/- 8.8（平均值 +/- 标准误）。在非快速眼动睡眠期间，PSG 3（29 +/- 10）的A + H/I低于PSG 2（54.3 +/- 11.3）（p = 0.004），且低于PSG 1（70.8 +/- 10.3）（p = 0.003）。同样，在非快速眼动睡眠期间，PSG 3（16.1 +/- 7.4）的呼吸暂停指数（AI）低于PSG 2（39.1 +/- 10.4）（p = 0.003），且低于PSG 1（41.7 +/- 9.6）（p = 0.015）。在所有三项多导睡眠图检查中均记录到快速眼动睡眠的8例患者中，A + H/I或AI没有差异。在非快速眼动睡眠期间，PSG 3期间的最低血氧饱和度（SaO2）高于PSG 1期间（p = 0.002），但与PSG 2期间无差异。三项研究在与快速眼动相关的最低SaO2方面没有差异；然而，在三项多导睡眠图检查中存在大量个体差异。一般来说，在PSG 2中睡眠呼吸障碍得到满意改善的个体在PSG 3中表现出类似的改善。在术后早期没有显著改善的患者在PSG 3中通常有改善，但在这方面存在大量个体差异。我们得出结论，对于患有阻塞性睡眠呼吸障碍的患者，在UPPP后几天内进行多导睡眠图检查是必要的，以确定术后早期睡眠期间上气道功能或氧合（或两者）是否恶化。UPPP后早期的满意结果表明术后晚期的多导睡眠图检查是不必要的，可节省成本并带来便利。
