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用于阻塞性睡眠呼吸暂停的鼻咽气道支架装置:系统评价与荟萃分析

Nasopharyngeal airway stenting devices for obstructive sleep apnoea: a systematic review and meta-analysis.

作者信息

Kumar A R, Guilleminault C, Certal V, Li D, Capasso R, Camacho M

机构信息

Stanford University School of Medicine,California,USA.

Department of Psychiatry,Sleep Medicine Division,Stanford Hospital and Clinics,Redwood City,California,USA.

出版信息

J Laryngol Otol. 2015 Jan;129(1):2-10. doi: 10.1017/S0022215114003119. Epub 2014 Dec 29.

Abstract

OBJECTIVE

To systematically review outcomes of adults with obstructive sleep apnoea treated with nasopharyngeal airway stenting devices.

METHODS

Medline, Scopus, Web of Science and the Cochrane Library databases were searched, and data on device use and tolerability, sleepiness, oxygen saturation, apnoea index, apnoea-hypopnoea index, and sleep quality were collected.

RESULTS

Of 573 potential studies, 29 were retrieved for detailed evaluation and 16 met the study criteria. Polysomnography data for patients treated with nasal trumpets as an isolated therapy were pooled for meta-analysis. The mean apnoea index ± standard deviation, for 53 patients, decreased from 32.4 ± 15.9 to 9.0 ± 7.2 episodes per hour (p < 0.00001). The mean apnoea-hypopnoea index, for 193 patients, decreased from 44.1 ± 18.9 to 22.7 ± 19.3 episodes per hour (p < 0.00001). The mean lowest oxygen saturation, for 193 patients, increased from 66.5 ± 14.2 to 75.5 ± 13.9 per cent (p < 0.00001).

CONCLUSION

Some studies have demonstrated limited effectiveness and low tolerability of nasopharyngeal airway stenting devices, while other studies have shown a significant benefit in treating obstructive sleep apnoea, with a high level of patient acceptance. Nasal trumpets have been successful in decreasing airway obstruction in the short term.

摘要

目的

系统评价使用鼻咽气道支架装置治疗的成人阻塞性睡眠呼吸暂停患者的治疗效果。

方法

检索了Medline、Scopus、Web of Science和Cochrane图书馆数据库,并收集了有关装置使用和耐受性、嗜睡、血氧饱和度、呼吸暂停指数、呼吸暂停低通气指数和睡眠质量的数据。

结果

在573项潜在研究中,检索到29项进行详细评估,其中16项符合研究标准。将单独使用鼻导管治疗的患者的多导睡眠图数据汇总进行荟萃分析。53例患者的平均呼吸暂停指数±标准差从每小时32.4±15.9次发作降至9.0±7.2次发作(p<0.00001)。193例患者的平均呼吸暂停低通气指数从每小时44.1±18.9次发作降至22.7±19.3次发作(p<0.00001)。193例患者的平均最低血氧饱和度从66.5±14.2%升至75.5±13.9%(p<0.00001)。

结论

一些研究表明鼻咽气道支架装置的有效性有限且耐受性低,而其他研究则显示在治疗阻塞性睡眠呼吸暂停方面有显著益处,患者接受度高。鼻导管在短期内成功地减少了气道阻塞。

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