山东大学耳鼻喉眼学报 ›› 2013, Vol. 27 ›› Issue (1): 12-15.doi: 10.6040/j.issn.1673-3770.0.2012.218

• 睡眠呼吸障碍性疾病 • 上一篇    下一篇

单纯鼻部手术对伴有鼻阻的阻塞性睡眠呼吸暂停低通气综合征患者睡眠的影响

曹鄂洪1,朱美英1,施毅1,宋勇1,陈剑秋2   

  1. 1.南京军区南京总医院呼吸与危重病科, 南京 210002;
    2.济南军区总医院耳鼻咽喉头颈外科, 济南  250031.
  • 发布日期:2013-02-16
  • 通讯作者: 陈剑秋。E-mail:jianqiuc2008@yahoo.com.cn
  • 作者简介:曹鄂洪。E-mail:ehcao@sina.com

Effectiveness of nasal surgery on sleep in patients with obstructive sleep apnea hypopnea syndrome and nasal obstruction

CAO E-hong1, ZHU Mei-ying1, SHI Yi1, SONG Yong1, CHEN Jian-qiu2.   

  1. 1. Respiratory and Critical Care Division, General Hospital of Nanjing Command, Nanjing 210002, China;  2. Department of Otolaryngology Head and Neck Surgery, General Hospital of Jian Military Command, Jinan 250031, China
  • Published:2013-02-16

摘要:

目的   探讨对伴有鼻阻塞的阻塞性睡眠呼吸暂停低通气综合征(OSAHS)患者,仅单纯行鼻部手术,术后对患者睡眠质量、结构、体位及紊乱性睡眠呼吸(SDB)的影响。方法   对鼻阻塞OSAHS患者30例鼻部手术前后,进行多导睡眠仪(PSG)监测和Epworth嗜睡量表(ESS)评分,比较手术前后睡眠质量、结构、体位和SDS变化。结果   睡眠效率[(86.4±6.4)% ~ (89.4±6.8)%, P=0.043]、ESS评分(10.08±3.3 ~ 8.1±3.3, P=0.001)和睡眠R期[(15.5±4.0)%~(18.8±4.7)%, P=0.006]手术后有明显改变。觉醒指数(ArI)、其他睡眠期、侧卧位占睡眠时间比例、呼吸暂停低通气指数(AHI)、最低血氧饱和度(LSaO2)和鼾声术后差异无统计学意义。结论   单纯鼻腔手术可部分改善睡眠质量和结构,但对体位、鼾声和阻塞性睡眠呼吸暂停无影响。

关键词: 阻塞性;鼻阻塞;鼻部手术, 睡眠呼吸暂停

Abstract:

Objective   To evaluate the effectiveness of nasal surgery  on sleep quality, architecture, position, and sleep-disordered breathing (SDB) in the patients with obstructive sleep apnea-hypopnea syndrome (OSAHS) and nasal obstruction. Methods   30 patients with OSAHS and nasal obstruction, who underwent the nasal surgery, were enrolled in the study. Polysomnographic(PSG) data and Epworth Sleepiness Scale(ESS) evaluation were performed, and the relationship  with sleep quality (sleep efficiency [SE] and arousal index [ArI]), sleep architecture, the distribution of sleep positions, and SDB (apnea-hypopnea index [AHI], minimum arterial oxygen saturation [LSaO2], and snoring) before and after nasal surgery were analyzed. Results   After the nasal surgery, sleep efficiency [from (86.4±6.4)% to (89.4±6.8)%, P=0.043], ESS evaluation (from 10.08±3.3 to 8.1±3.3, P=0.001) and stage R [from (15.5±4.0)% to (18.8±4.7)%, P=0.006] were significantly changed, however, there was no significant change in ArI, other sleep stages, the proportion of sleep time spent in the supine position, AHI, LSaO2 or snoring. Conclusion   Nasal surgery alone is partially effective in improving sleep quality and architecture, but it shows no effect on the distribution of sleep positions, snoring and obstructive apnea in patients with OSAHS and nasal obstruction.

Key words: Sleep apnea, obstructive, Nasal obstruction, Nasal surgery

中图分类号: 

  • R766.7
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