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鼻部手术对体位性和非体位性阻塞性睡眠呼吸暂停/低通气患者的多导睡眠图影响。

Polysomnographic effect of nasal surgery on positional and non-positional obstructive sleep apnea/hypopnea patients.

作者信息

Hu Bin, Han Demin, Li Yunchuan, Ye Jingying, Zang Hongrui, Wang Tong

机构信息

Department of Otolaryngology-Head and Neck Surgery, National Key Discipline, Key Laboratory of Otolaryngology Head and Neck Surgery of Ministry of Education, Beijing Tongren Hospital, Capital Medical University, Beijing, China.

出版信息

Acta Otolaryngol. 2013 Aug;133(8):858-65. doi: 10.3109/00016489.2013.782507. Epub 2013 May 13.

Abstract

CONCLUSION

The polysomnographic (PSG) effects of nasal surgery on positional obstructive sleep apnea/hypopnea syndrome (OSAHS) patients (PPs) and non-positional OSAHS patients (NPPs) were different.

OBJECTIVE

We aimed to determine the PSG data changes after nasal surgery and evaluate the PSG effect of nasal surgery on PPs and NPPs, respectively.

METHODS

A total of 79 OSAHS patients with nasal obstruction were recruited. Preoperative rhinomanometry and overnight polysomnography were recorded. Patients were distributed into three groups based on the severity level of the apnea and hypopnea indexes (AHI) (mild, moderate, and severe OSAHS). Three groups were each subdivided into two subgroups (PPs and NPPs). Postoperative data were obtained at least 6 months later.

RESULTS

After surgery, although nasal resistance decreased significantly in all patients, the total rate of success and response in treating OSAHS was only 22.7%. Grouped on the basis of the severity level of AHI, the lowest SpO2 increased and AHI, supine AHI, and arousal indexes decreased significantly only in mild OSAHS (p < 0.05). Subdivided according to the presence or absence of positional dependency, the lowest SpO2 increased and supine AHI decreased significantly in both PPs and NPPs with mild OSAHS and in PPs with moderate OSAHS (p < 0.05). AHI significantly increased in PPs with severe OSAHS (p < 0.05). Supine sleep time was relatively prolonged significantly in PPs with moderate and severe OSAHS (p < 0.05).

摘要

结论

鼻部手术对体位性阻塞性睡眠呼吸暂停低通气综合征(OSAHS)患者(PPs)和非体位性OSAHS患者(NPPs)的多导睡眠图(PSG)影响不同。

目的

我们旨在确定鼻部手术后的PSG数据变化,并分别评估鼻部手术对PPs和NPPs的PSG效果。

方法

共招募了79例伴有鼻塞的OSAHS患者。记录术前鼻阻力和整夜多导睡眠图。根据呼吸暂停低通气指数(AHI)的严重程度将患者分为三组(轻度、中度和重度OSAHS)。三组再各自细分为两个亚组(PPs和NPPs)。术后数据至少在6个月后获取。

结果

术后,尽管所有患者的鼻阻力均显著降低,但治疗OSAHS的总成功率和有效率仅为22.7%。根据AHI严重程度分组,仅在轻度OSAHS患者中,最低SpO2升高,AHI、仰卧位AHI和觉醒指数显著降低(p<0.05)。根据是否存在体位依赖性细分,轻度OSAHS的PPs和NPPs以及中度OSAHS的PPs中,最低SpO2升高,仰卧位AHI显著降低(p<0.05)。重度OSAHS的PPs中AHI显著升高(p<0.05)。中度和重度OSAHS的PPs中仰卧位睡眠时间相对显著延长(p<0.05)。

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