药物诱导睡眠内镜检查结果与低氧血症相关性研究

doi:10.6040/j.issn.1673-3770.0.2016.205

摘要/Abstract

摘要： 目的通过回顾药物诱导睡眠内镜检查结果,寻找阻塞性睡眠呼吸暂停低通气综合征(OSAHS)患者上气道塌陷形态与多导睡眠监测结果的关联。方法经多导睡眠监测(PSG)诊断为OSAHS的患者51例,右美托咪定诱导睡眠后内镜观察仰卧位患者睡眠期腭咽、口咽侧壁、舌根、会厌和喉部5个部位的塌陷情况,并分析与多导睡眠监测仪(PSG)监测参数的相关性。结果腭咽部完全阻塞患者的呼吸暂停指数(AHI)、氧降指数(ODI)、血氧饱和度低于90%时间比(T<90%)明显高于不完全阻塞患者,最低血氧饱和度(LSaO₂)明显低于不完全阻塞患者。口咽部塌陷方向均为X轴方向,即表现为侧壁塌陷,完全阻塞或不完全阻塞患者相较无阻塞患者,有着明显增高的AHI、ODI和T<90%,明显降低的LSaO₂。结论口咽侧壁及腭咽部的阻塞表现出更明显的低氧血症,需要重视并予以积极治疗。

关键词: 右美托咪定, 多导睡眠监测, 气道阻塞, 内窥镜检查, 睡眠呼吸暂停,阻塞性

Abstract: Objective To explore the correlation between patterns of upper airway collapse and results of polysomnography(PSG)in patients with obstructive sleep apnea-hypopnoea syndrome(OSAHS)by reviewing drug-induced sleep endoscopy(DISE)findings. Methods A total of 51 OSAHS cases confirmed by PSG underwent DISE after taking dexmedetomidine. The findings were observed using the VOTEL(velum, oropharynx, tongue base, epiglottis and larynx)classification system. Associations between DISE and polysomnographic parameters were analyzed. Results Both velum collapse and complete lateral oropharyngeal collapse were significantly associated with increased severity of OSAHS, reflected by elevated apnea-hypopnea index(AHI), oxygen desaturation index(ODI), and T<90%, but decreased lowest oxygen saturation(LSaO₂). If both collapses were on the X axis, the collapses were presented as lateral collapses. Conclusion There is strong association between complete lateral oropharyngeal wall and velum collapse and increased OSAHS severity.

Key words: Polysomnography, Endoscopy, Airway obstruction, Sleep apnea, Obstructive, Dexmedetomidine

中图分类号:

R766.7

周鹏,神平,刘稳,李培华,李红权. 药物诱导睡眠内镜检查结果与低氧血症相关性研究[J]. 山东大学耳鼻喉眼学报, 2016, 30(5): 54-57.

ZHOU Peng, SHEN Ping, LIU Wen, LI Peihua, LI Hongquan. Association between findings of drug-induced sleep endoscopy and hypoxemia.[J]. JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY), 2016, 30(5): 54-57.

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