正压通气与上气道多平面手术治疗OSAHS研究进展

王杰; 李莹; 林忠辉; 宋柠颖

doi:10.13201/j.issn.1001-1781.2013.18.019

正压通气与上气道多平面手术治疗OSAHS研究进展

- 1 绵阳市中心医院耳鼻咽喉-头颈外科(四川绵阳, 621000);
- 2 北京和睦家医院耳鼻咽喉-头颈外科;
- 3 四川大学华西医院耳鼻咽喉-头颈外科

详细信息

通讯作者: 宋柠颖,E-mail:songningying2@163.com

中图分类号: R563.8

收稿日期: 2012-03-01

Progress of positive airway pressure and upper airway multilevel surgeries in the treatment of obstructive sleep apnea-hypopnea syndrome

More Information

Corresponding author: SONG Ningying, E-mail: songningying2@163.com

Received Date: 01 March 2012

摘要

- 正压通气 /
- 上气道多平面手术 /
- 睡眠呼吸暂停低通气综合征,阻塞性 /
- 治疗
Abstract: This review focus on the progress of the treatment of obstructive sleep apnea-hypopnea syndrome by using positive airway pressure and upper airway multilevel surgeries.OSAHS is a disease caused by multiple etiologies.We should consider upper airway anatomical abnormalities and the severity of OSAHS before reasonable treatment plans were formulated. "PAP-surgery-PAP" is the classic procedure for treating moderate OSAHS and severe OSAHS.Preoperative use of PAP could reduce the hypoxic condition of patients and decrease surgical risk.Surgery can effectively reduce the optimal PAP pressure value, and increase the tolerance of patient.Postoperative use of PAP can improve surgical efficacy, shorten patient recovery time.However, the influence of different surgical methods on optimal PAP pressure value is lacking in large samples.More related studies need to be performed in the future.
- positive airway pressure /
- upper airway multi-level surgeries /
- sleep apnea-hypopnea syndrome,obstruetive /
- treatment

HTML全文

参考文献(38)

[1]	PARRA O, ARBOIX A, BECHICH S, et al. Time course of sleep-related breathing disorders in first-ever stroke or transient ischemic attack[J]. Am J Respir Crit Care Med, 2000,161:2375-2380.
[2]	STEIROPOULO P, PAPANAS N. Continuous positive airway pressure to improve insulin resistance and glucose homeostasis in sleep apnea[J]. World J Diabetes, 2011, 2:16-18.
[3]	RYAN C M, BAYLEY M, GREEN R, et al. Influence of contimuous positive airway pressure on outcomes of rehabilitation in stroke patients with obstructive sleep apnea[J]. Stroke, 2011,42:1062-1067.
[4]	MEURICE J C, MARC I, SERISE F. Efficacy of auto-CPAP in the treatment of obstructive sleep apnea/hypopnea syndrome[J].Am J Respir Crit Care Med, 1996, 153:794-798.
[5]	BALTZAN M A, KASSISSIA I, ELKHOLI O, et al. Prevalence of persistent sleep apnea in patients with continuous positive airway pressure[J]. Sleep, 2006, 29:557-563.
[6]	孟琨,孙玉发,王平.多导睡眠监测评估两种模式正压通气呼吸机对重度阻塞性睡眠呼吸暂停综合征的疗效[J].中国临床保健杂志,2010,13(4):354-356.
[7]	胡雪君.持续正压通气对阻塞性睡眠呼吸暂停患者睡眠质量改善作用[J].中国医科大学学报,2001,30(3):201-203.
[8]	王小平.CPAP对OSAHS患者睡眠质量的影响分析[J].基层医学论坛,2011,15(4):298-299.
[9]	黄隽英,赵敏艳,熊康平.OSAHS病人经Auto-CPAP滴定前后多导睡眠图变化观察[J].护理研究,2011,25(9):2403-2404.
[10]	LOREDO J S, ANCOLI-ISRAEL S, KIM E J, et al. Effect of continuous positive airway pressure versus supplemental oxygen on sleep quality inobstructive sleep apnea:a placebo-CPAP-controlled study[J]. Sleep, 2006,29:564-571.
[11]	JING J, HUANG T, CUI W, et al. Effect on quality of life of continuous positive airway pressure in patients with obstructive sleep apnea syndrome:a meta-analysis[J].Lung,2008,186:131-144.
[12]	AVLONITOU E, KAPSIMALIS F, VAROUCHAKIS G, et al. Adherence to CPAP therapy improves quality of life and reduces symptoms among obstructive sleep apnea syndrome patients[J].Sleep Breath,2011,Epub ahead of print.
[13]	ROBINSON G, STRADLING J, DAVIES R. Sleep 6:obstructive sleep apnoea/hypopnoea syndrome and hypertension[J]. Thorax, 2004,59:1089-1094.
[14]	BAYRAM N A, CIFTCI B, GUVEN S F, et al. Relationship between the severity of obstructive sleep apnea and hypertension[J]. Anadolu Kardiyol Derg, 2007,7:378-382.
[15]	ALAJMI M, MULGREW A T, FOX J, et al. Impact of continuous positive airway pressure therapy on blood pressure in patients with obstructive sleep apnea hypopnea:a meta-analysis of randomized controlled trails[J]. Lung, 2007,185:67-72.
[16]	ZHANG X L, YIN K S, LI C, et al. Effect of continuous positive airway pressure treatment on serum adiponectin level and mean arterial pressure in male patients with obstructive sleep apnea syndrome[J]. Chin Med J(Engl), 2007, 120:1477-1481.
[17]	BECKER H F, JERRENTRUP A, PLOCH T, et al. Effect of nasal continuous positive airway pressure treatment on blood pressure in patients with obstructive sleep apnea[J]. Circulation, 2003, 107:68-73.
[18]	SUZUKI M, SAIGUSA H, FURUKAWA T. Comparison of sleep parameters at titration and subsequent compliance between CPAP- pretreated and non- CPAP- pretreated patients with obstructive sleep apnea[J]. Sleep Med, 2007, 8:773-778.
[19]	IMADOJEMU V A, MAWJI Z, KUNSELMAN A, et al. Sympathetic chemoreflex responses in obstructive sleep apnea and effects of continuous positive airway pressure therapy[J]. Chest, 2007,131:1406-1413.
[20]	GRIMM W, BECKER H F. Obesity, sleep apnea syndrome, and rhythmogenic risk[J]. Herz, 2006, 31:213-218.
[21]	IESATO K, TATSUMI K, SAIBARA T, et al. Decreased lipoprotein lipase in obstructive sleep apnea syndrome[J]. Circ J, 2007,71:1293-1298.
[22]	ALCHANATIS M, TOURKOHRITI G, KAKOUROS S, et al. Daytime pulmonary hypertension in patients with obstructive sleep apnea:the effect of continuous positive airway pressure on pulmonary hemodynamics[J]. Respiration, 2001, 68:566-572.
[23]	LARSSON L G, LINDBERG A, FRANKLIN K A, et al. Obstructive sleep apnea syndrome is common in subjects with chronic bronchitis. Report from the obstructive lung disease in northern Sweden studies[J]. Respiration, 2001, 68:250-255.
[24]	RYAN C F, LOWE A A, LID D, et al. Magnetic resonance imaging of the upper airway in obstructive sleep apnea before and after chronic nasal continuous positive airway pressure therapy[J].Am Rev Despir Dis,1991,144:930-944.
[25]	AOUAD L J, TAM K, WATERS K A. Effects of acute intermittent hypercapnic hypoxia on insulin sensitivity in piglets using euglycemic clamp[J]. Metabolism, 2008, 57:1056-1063.
[26]	MESLIER N, CAGNADOUX F, GIRAUD P, et al. Impaired glucose-insulin metabolism in males with obstructive sleep apnea syndrome[J]. Eur Respir J, 2003, 22:156-160.
[27]	IGOR A H, SIMIN P S, MARTIN R T. CPAP treatment rapidly improves Insulin Sensitivity in patients with OSAS Am[J]. J Respir Crit Care Med, 2004,169:156-162.
[28]	韩德民,王军,叶京英,等.腭咽成形术中保留悬雍垂的意义[J].中华耳鼻咽喉科杂志,2000,35(3):215-218.
[29]	MAW J M. Uvulopalatopha ryngoplasty versus laser-assisted uvulopalatopharyngoplasty in the treatment od snoring[J]. J Otolaryngol, 1997,26:232-235.
[30]	BERTOLETTI F, INDELICATO A, BANFI P, et al. Sleep apnea/hypopnoea syndrome:combination therapy with the Pillar palatal implant technique and continuous positive airway pressure(CPAP)[J]. A preliminary Report,2009, 5:251-257.
[31]	CHOI J H, KIM S N, CHO J H. Efficacy of the pillar implant in the treatment of snoring and mild-to-moderate obstructive sleep apnea:a meta-analysis[J]. Laryngoscope, 2012, Epub of print.
[32]	邹帆,邝韶景,高明华,等.Pillar植入系统联合鼻部手术治疗OSAHS 38例疗效分析[J].重庆医学,2010,39(8):917-918.
[33]	林忠辉,韩德民,林宇华.重度阻塞性睡眠呼吸暂停低通气综合征围手术期持续正压通气治疗[J].中华耳鼻咽喉科杂志,2003,38(3):172-175.
[34]	王红梅,王林,刘吉祥.短期持续正压通气治疗对阻塞新睡眠呼吸暂停低通气综合征伴2型糖尿病患者胰岛素敏感性的影响[J].临床耳鼻咽喉头颈外科杂志,2008,22(13):597-599.
[35]	HERTEGONNE K B, VOLNA J, PORTIER S, et al. Titration procedures for nasal CPAP:Automatic CPAP or prediction formula[J]?Sleep Med, 2008, 9:732-738.
[36]	马春玲.解除鼻部疾病后提高睡眠呼吸暂停综合征患者对CPAP的耐受性[J].实用医技杂志,2003, 11(10):1307-1308.
[37]	MORTIMORE I L, BRADLEY P A, MURRAY J A, et al. Uvulopalatopharyngoplasty may compromise nasal CPAP therapy in sleep apnea syndrome[J].Am J Respir Crit Care Med, 1996, 154:1759-1762.
[38]	张立红,韩芳,宋文采,等.传统及改良悬雍垂腭咽成形术对持续正压通气治疗的影响[J].中华耳鼻咽喉科杂志,2003, 38(3):176-179.