持续气道正压通气治疗对鼻腔通畅度的影响。

The effect of continuous positive airway pressure therapy on nasal patency.

机构信息

Department of Otolaryngology and Communicative Sciences, University of Mississippi Medical Center, Jackson, MS.

The Baton Rouge Clinic, A Medical Corporation, Baton Rouge, LA.

出版信息

Int Forum Allergy Rhinol. 2018 Oct;8(10):1136-1144. doi: 10.1002/alr.22157. Epub 2018 Jun 13.

DOI:10.1002/alr.22157

PMID:29897663

Abstract

BACKGROUND

Nasal congestion and obstruction are reported in the majority of continuous positive airway pressure (CPAP) users and are frequently cited as reasons for noncompliance. To our knowledge, no study has demonstrated a change in objective or subjective nasal patency in patients with obstructive sleep apnea (OSA) after a therapeutic trial of CPAP therapy.

METHODS

This prospective nonrandomized trial tested the hypothesis that CPAP therapy would result in both objective and subjective improvements in nasal patency in patients with OSA. Prior to initiation of CPAP, acoustic rhinometry (AR) was used to determine nasal volume and minimum cross-sectional area in the upright and reclined positions. Subjective nasal patency was assessed with the Nasal Obstruction Symptom Evaluation (NOSE) questionnaire. Both assessments were repeated at follow-up visits.

RESULTS

AR data demonstrated a statistically significant increase in total nasal volume (TV) in the reclined position (p = 0.002) and minimum cross-sectional area (MCA) in both the sitting and reclined positions (p = 0.006, p = 0.021) in OSA patients after >30 days of CPAP therapy and with >70% compliance. NOSE scores decreased significantly (p = 0.038) representing an improvement in nasal patency.

CONCLUSION

Objective and subjective measurements of TV and MCA increased after initiation of CPAP therapy in this prospective study.

摘要

背景

持续气道正压通气（CPAP）的大多数使用者都会出现鼻塞和阻塞的情况，并且经常被认为是不依从治疗的原因。据我们所知，在接受 CPAP 治疗的治疗性试验后，没有研究表明阻塞性睡眠呼吸暂停（OSA）患者的客观或主观鼻腔通畅度发生了变化。

方法

这项前瞻性非随机试验检验了以下假设：CPAP 治疗将导致 OSA 患者的鼻腔通畅度在客观和主观上均得到改善。在开始 CPAP 治疗之前，使用声鼻测量法（AR）来确定直立和倾斜位置的鼻腔容积和最小横截面积。使用鼻腔阻塞症状评估（NOSE）问卷评估主观鼻腔通畅度。在随访时重复这两项评估。

结果

AR 数据表明，在接受 CPAP 治疗>30 天后，70%以上的患者依从性良好，OSA 患者的倾斜位置总鼻腔容积（TV）和最小横截面积（MCA）均有统计学意义的增加（p=0.002，p=0.021），并且在坐立和倾斜位置的 MCA 均有统计学意义的增加（p=0.006，p=0.021）。NOSE 评分显著降低（p=0.038），代表鼻腔通畅度得到改善。