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药物诱导睡眠内镜检查对伴有中风或短暂性脑缺血发作患者阻塞性睡眠呼吸暂停的评估

Evaluation of Obstructive Sleep Apnea by Drug Induced Sleep Endoscopy in Pateints Presenting with Stroke or Transient Ischemic Attack.

作者信息

Rathore Raina, Tandon Shruti, Gaur Sushil

机构信息

Department of ENT, Santosh Medical College and Hospital, Ambedkar Road Maliwara Nehru Nagar, Ghaziabad, 201001 Uttar Pradesh India.

出版信息

Indian J Otolaryngol Head Neck Surg. 2024 Oct;76(5):3978-3985. doi: 10.1007/s12070-024-04758-w. Epub 2024 May 24.

Abstract

UNLABELLED

Obstructive Sleep Apnea Hypopnea (OSAHS) Syndrome is defined by repetitive episodes of apneas or hypopneas, excessive daytime somnolence; waking up during sleep with gasping, choking, or breath holding; or witnessed reports of apneas, loud snoring, or both. The current gold standard diagnostic test for OSAS is polysomnography. A total of 30 patients diagnosed with stroke and OSA at tertiary care hospital were included in this study. They underwent clinical evaluation and investigations including polysomnography. They were then subjected to drug induced sleep endoscopy and findings were noted according to VOTE classification. Patients belonged to age groups ranging from 3 to 8 decade of life. Mean BMI was found to be 33.02 (+/-8.37) where 73.33% patients were overweight and obese category. Multilevel obstruction was present in 96.67% of patients Oropharynx was most common site of obstruction in our study. Velum(86.6%) was 2nd most common site of obstruction. This was the most common type of obstruction in our study was multilevel collapse (46.67%) including all 4 sites i.e. velum, oropharynx, tongue base and epiglottis. BMI in this study was found to have insignificant correlation with multi-level severe obstruction ( = 0.306). Obstructive sleep apnoea is a common finding in majority of patients suffering from chronic lifestyle diseases. In our study, we found that DISE is easy to perform, safe and reliable tool for evaluation of OSA with CVA patients as the majority of these patients have multi-level obstruction. The procedure also provides important information about dynamic changes in upper airway during sleep. Multilevel obstruction is the most common obstruction.

SUPPLEMENTARY INFORMATION

The online version contains supplementary material available at 10.1007/s12070-024-04758-w.

摘要

未标注

阻塞性睡眠呼吸暂停低通气(OSAHS)综合征的定义为反复出现呼吸暂停或低通气发作、日间过度嗜睡;睡眠中因喘气、窒息或屏气而醒来;或有呼吸暂停、大声打鼾或两者皆有的目击报告。目前OSAS的金标准诊断测试是多导睡眠图。本研究纳入了一家三级医院诊断为中风和OSA的30名患者。他们接受了包括多导睡眠图在内的临床评估和检查。然后对他们进行药物诱导睡眠内镜检查,并根据VOTE分类记录结果。患者年龄在3岁至80岁之间。平均体重指数为33.02(±8.37),其中73.33%的患者属于超重和肥胖类别。96.67%的患者存在多平面阻塞。在我们的研究中,口咽是最常见的阻塞部位。软腭(86.6%)是第二常见的阻塞部位。本研究中最常见的阻塞类型是多平面塌陷(46.67%),包括所有4个部位,即软腭、口咽、舌根和会厌。本研究发现体重指数与多平面严重阻塞之间无显著相关性(r = 0.306)。阻塞性睡眠呼吸暂停在大多数患有慢性生活方式疾病的患者中很常见。在我们的研究中,我们发现药物诱导睡眠内镜检查是评估CVA患者OSA的一种易于实施、安全可靠的工具,因为这些患者中的大多数存在多平面阻塞。该检查还提供了睡眠期间上气道动态变化的重要信息。多平面阻塞是最常见的阻塞类型。

补充信息

在线版本包含可在10.1007/s12070-024-04758-w获取的补充材料。

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