Peter J H, Cassel W, Faust M, Penzel T, Ploch T, Schulze B
Medizinische Universitäts-Poliklinik, Zeitreihenlabor, Marburg.
Pneumologie. 1993 Mar;47 Suppl 1:104-7.
Sleep apnoea (SA) ist a challenge to clinical research, since it occurs in up to 10% of the male professionally active population. It is indeed a challenge in respect of diagnosis, clinical aspects and therapy. SA is not only responsible for mental handicaps during daytime caused by disturbed sleep (increased tendency to doze or fall asleep, proneness to accidents), it will also enhance morbidity and mortality in aspect of cardiopulmonary and cardiovascular diseases (hypertension, cardiac insufficiency, disturbances of cardiac rhythm). All kinds of secondary and/or subsequent damage are reversible, provided diagnosis and rigidly introduced and maintained treatment have been performed well in time. SA can be diagnosed, treated and followed up by means of methods that can be flexibly employed outside the hospital, i.e. on an outpatient basis, such as questionnaires, MESAM IV, behavioural counselling, drug therapy). Within the framework of the current three-year project a stepwise concept was developed for diagnosis and treatment that also includes outpatient examination procedures. This system integrates anamnesis, outpatient monitoring, sleep laboratory, therapy and therapy control into a comprehensive feedback system of patient care. The following standardised procedural steps are included in the outpatient part of this system: baseline examination, treatment that can be performed on an outpatient basis, short-term, medium-term and long-term therapy follow-up. If these steps do not yield satisfactory results or if there is a high acute risk, the patient is subjected to in-patient treatment. At present, 683 first examinations and 420 follow-ups have been recorded.(ABSTRACT TRUNCATED AT 250 WORDS)
睡眠呼吸暂停(SA)对临床研究而言是一项挑战,因为在职业活跃的男性人群中,其发生率高达10%。在诊断、临床方面及治疗上,它确实是个难题。SA不仅会导致因睡眠紊乱引起的白天精神障碍(打盹或入睡倾向增加、易发生事故),还会在心肺和心血管疾病(高血压、心脏功能不全、心律紊乱)方面增加发病率和死亡率。只要及时进行了良好的诊断以及严格实施并维持治疗,各类继发性和/或后续损害都是可逆的。SA可通过一些能在院外灵活应用的方法进行诊断、治疗及随访,即门诊方式,如问卷调查、MESAM IV、行为咨询、药物治疗等。在当前这个为期三年的项目框架内,已制定了一个用于诊断和治疗的逐步概念,其中也包括门诊检查程序。该系统将问诊、门诊监测、睡眠实验室、治疗及治疗控制整合到一个全面的患者护理反馈系统中。该系统门诊部分包括以下标准化程序步骤:基线检查、可在门诊进行的治疗、短期、中期和长期治疗随访。如果这些步骤未取得满意结果,或者存在高急性风险,则让患者接受住院治疗。目前,已记录了683例初次检查和420例随访。(摘要截选至250字)