[鼻咽通气道联合多导睡眠图对上气道梗阻定位的临床价值初步研究]

[Preliminary research on clinical value of localization of upper airway obstruction with nasopharyngeal airway combined with polysomnography].

作者信息

Huo Hong, Li Wuyi, Tian Xu, Yu Rong, Wang Jian, Xu Chunxiao, Yang Dahai

机构信息

Department of Otorhinolaryngology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100730, China.

Department of Otorhinolaryngology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100730, China? Email:

出版信息

Zhonghua Er Bi Yan Hou Tou Jing Wai Ke Za Zhi. 2014 Sep;49(9):743-7.

PMID:25487584

Abstract

OBJECTIVE

To investigate the clinical value of localization of upper airway obstructive site with the method of combination of nasopharyngeal airway and polysomnography (PSG).

METHODS

Forty-seven patients diagnosed as obstructive sleep apnea hypopnea syndrome (OSAHS) by PSG were enrolled. Each patient was examined by Somte PSG for the first night, underwent repeated PSG examination with the nasopharyngeal airway in place for the second night and received airway continuous pressure measurements (ApneaGraph) examination for the third night. The standard of treatment success was defined as apnea-hypopnea index (AHI) less than 20/h and a reduction of 50% or more. The patients were divided into success group and failure group. The PSG indices and ApneaGraph data of the two groups were compared. Correlations between AHI with nasopharyngeal airway in place by PSG and lower AHI and constituent ratio of lower obstruction by ApneaGraph were calculated. SPSS 17.0 software was used to analyze the data.

RESULTS

Forty-two patients completal three-night examination. With the nasopharyngeal airway in place, AHI, the lowest oxyhemoglobin saturation (LSaO2), average oxyhemoglobin saturation, percent of sleep time with oxyhemoglobin saturation <0.90 (SaO2 < 0.90T%) were improved obviously (P < 0.001). Twenty-nine patients (69.0%) achieved treatment success. There were statistical differences (t = 2.670, P = 0.011; Z = -3.252, P = 0.001 and t = -4.556, P < 0.001) of LSaO2 by PSG, lower AHI and constituent ratio of lower obstruction by ApneaGraph compared success group with failure group. The correlations between AHI with nasopharyngeal airway in place by PSG and lower AHI and constituent ratio of lower obstruction by ApneaGraph were 0.616 (P < 0.001) and 0.526 (P < 0.001).

CONCLUSION

The method of combination of nasopharyngeal airway with PSG is a reliable method of localization of upper airway obstructive site and can be used as a simple means to find out if there's any retroglossal obstruction.

摘要

目的

探讨鼻咽气道联合多导睡眠图（PSG）定位上气道阻塞部位的临床价值。

方法

纳入47例经PSG诊断为阻塞性睡眠呼吸暂停低通气综合征（OSAHS）的患者。所有患者第一晚行Somte PSG检查，第二晚佩戴鼻咽气道后重复PSG检查，第三晚行气道持续压力测定（ApneaGraph）检查。治疗成功标准定义为呼吸暂停低通气指数（AHI）小于20次/小时且降低50%以上。将患者分为成功组和失败组，比较两组的PSG指标及ApneaGraph数据。计算PSG佩戴鼻咽气道时的AHI与较低AHI以及ApneaGraph下咽部阻塞构成比之间的相关性。采用SPSS 17.0软件进行数据分析。

结果

42例患者完成三晚检查。佩戴鼻咽气道后，AHI、最低血氧饱和度（LSaO2）、平均血氧饱和度、血氧饱和度<0.90的睡眠时间百分比（SaO2<0.90T%）均明显改善（P<0.001）。29例患者（69.0%）治疗成功。成功组与失败组比较，PSG的LSaO2、较低AHI及ApneaGraph下咽部阻塞构成比差异有统计学意义（t = 2.670，P = 0.011；Z = -3.252，P = 0.001；t = -4.556，P<0.001）。PSG佩戴鼻咽气道时的AHI与较低AHI以及ApneaGraph下咽部阻塞构成比之间的相关性分别为0.616（P<0.001）和0.526（P<0.001）。