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阻塞性睡眠呼吸暂停患者上气道刺激的短期结果:阿姆斯特丹的经验

Short-term results of upper airway stimulation in obstructive sleep apnoea patients: the Amsterdam experience.

作者信息

Vonk P E, Ravesloot M J L, van Maanen J P, de Vries N

机构信息

Department of Otorhinolaryngology - Head and Neck Surgery, Onze Lieve Vrouwe Gasthuis ('OLVG'), Amsterdam, the Netherlands.

Department of Otorhinolaryngology - Head and Neck Surgery, Amsterdam UMC, location AMC, the Netherlands.

出版信息

J Laryngol Otol. 2020 May;134(5):447-452. doi: 10.1017/S0022215120000961. Epub 2020 Jun 3.

Abstract

OBJECTIVES

This paper aimed to: retrospectively analyse single-centre results in terms of surgical success, respiratory outcomes and adverse events after short-term follow up in obstructive sleep apnoea patients treated with upper airway stimulation; and evaluate the correlation between pre-operative drug-induced sleep endoscopy findings and surgical success.

METHODS

A retrospective descriptive cohort study was conducted, including a consecutive series of obstructive sleep apnoea patients undergoing implantation of an upper airway stimulation system.

RESULTS

Forty-four patients were included. The total median Apnoea-Hypopnea Index and oxygen desaturation index significantly decreased from 37.6 to 8.3 events per hour (p < 0.001) and from 37.1 to 15.9 events per hour (p < 0.001), respectively. The surgical success rate was 88.6 per cent, and did not significantly differ between patients with or without complete collapse at the retropalatal level (p = 0.784). The most common therapy-related adverse event reported was (temporary) stimulation-related discomfort.

CONCLUSION

Upper airway stimulation is an effective and safe treatment in obstructive sleep apnoea patients with continuous positive airway pressure intolerance or failure. There was no significant difference in surgical outcome between patients with tongue base collapse with or without complete anteroposterior collapse at the level of the palate.

摘要

目的

本文旨在:回顾性分析上气道刺激治疗阻塞性睡眠呼吸暂停患者短期随访后的手术成功率、呼吸结局及不良事件的单中心结果;并评估术前药物诱导睡眠内镜检查结果与手术成功率之间的相关性。

方法

进行了一项回顾性描述性队列研究,纳入了连续一系列接受上气道刺激系统植入的阻塞性睡眠呼吸暂停患者。

结果

纳入44例患者。总呼吸暂停低通气指数和氧饱和度下降指数分别从每小时37.6次显著降至8.3次(p < 0.001)和从每小时37.1次显著降至15.9次(p < 0.001)。手术成功率为88.6%,软腭后水平完全塌陷和未完全塌陷的患者之间无显著差异(p = 0.784)。报告的最常见治疗相关不良事件是(暂时的)刺激相关不适。

结论

上气道刺激对于气道正压通气不耐受或失败的阻塞性睡眠呼吸暂停患者是一种有效且安全的治疗方法。软腭水平有或无前、后位完全塌陷的舌根塌陷患者的手术结果无显著差异。

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