持续气道正压通气联合口腔阻鼾器治疗重度阻塞性睡眠呼吸暂停低通气综合征疗效分析

王金凤; 马薇; 谢宇平; 惠培林; 赵丽君; 魏晓泉; 周丽雅

doi:10.13201/j.issn.1001-1781.2015.23.008

持续气道正压通气联合口腔阻鼾器治疗重度阻塞性睡眠呼吸暂停低通气综合征疗效分析

- 甘肃省人民医院睡眠医学中心
基金项目:
甘肃省技术研究与开发专项计划(No:1305TCYA031)

国家自然科学基金(No:81560228)

详细信息

通讯作者: 谢宇平,E-mail:xyp5894@163.com

中图分类号: R563.8

收稿日期: 2015-06-23

The curative effect analysis of continuous positive airway pressure combined with modified oral appliance in the treatment of severe OSAHS

- Sleep Medicine Center, Gansu Provincial People Hospital, Basic Medical College of Lanzhou University, Lanzhou, 730000, China

More Information

Corresponding author: XIE Yuping, E-mail: xyp5894@163.com

Received Date: 23 June 2015

摘要

摘要: 目的: 探讨持续气道正压通气(CPAP)联合阻鼾器治疗重度阻塞性睡眠呼吸暂停低通气综合征(OSAHS)的疗效。方法: 对120例男性重度OSAHS患者分别采用CPAP联合阻鼾器(30例)、CPAP(30例)和阻鼾器(30例)治疗,抽取同期年龄、BMI、颈围等相匹配的未采用任何治疗的重度OSAHS患者30例作为对照组。治疗3个月后,对比观察各组治疗前后PSG的特征及呼吸机佩戴情况。结果: CPAP联合阻鼾器组ESS评分显著低于CPAP组、阻鼾器组及对照组(P<0.05)。治疗3个月后,CPAP联合阻鼾器组及CPAP组AHI、微觉醒指数(AI)、N1期及N2期占总睡眠时间(TST)比例显著低于阻鼾器组及对照组(P<0.05);睡眠效率、ESS评分、平均血氧饱和度(MSaO₂)、LSaO₂、慢波睡眠期(SWS)及REM期占TST的比例显著增加(P<0.05);CPAP联合阻鼾器组和CPAP组的AHI、MSaO₂、AI、睡眠效率及N1、N2、SWS、REM期占TST百分比及ESS评分无显著性差异(P>0.05)。CPAP联合阻鼾器组LSaO₂、平均带机时间显著大于CPAP组(P<0.05),90%压力及平均漏气量显著低于CPAP组(P<0.05)。结论: CPAP联合阻鼾器治疗重度OSAHS的疗效优于单纯CPAP及阻鼾器治疗。
- 睡眠呼吸暂停低通气综合征 /
- 阻塞性 /
- 持续气道正压通气 /
- 口腔阻鼾器
Abstract: Objective: To evaluate the curative effect of continuous positive airway pressure(CPAP) combined with modified oral appliance(MOA) in the treatment of severe OSAHS. Method: The research chose 120 male patients with severe OSAHS. They were treated with CPAP and MOA (30 cases), CPAP (30 cases), and MOA (30 cases) respectively. At the same time, the rest 30 cases without any treatment were in control group(matching factors:age, gender, IBM). After 3 months treatment, the characteristics of PSG and respiratory machine wear condition were observated in four groups. Result: The ESS score in CPAP and MOA group was significantly lower than that in other groups (P<0.05); After 3 months treatment, the AHI, awake index(AI), and N1 (non-rapid eyemovement sleep1,N1) and N2 (non-rapid eyemovement sleep2,N2) period of total sleep time (TST) percentage in CPAP assisted MOA group and CPAP group were significantly lower than that in MOA group and control group (P<0.05); Sleep efficiency, ESS score, average blood oxygen saturation (MSaO₂),the lowest oxygen saturation (LSaO₂),slow wave sleep phases (SWS) and rapid eyemovement sleep (REM) accounted for the proportion of TST increased significantly (P<0.05); There was no significant difference between CPAP assisted MOA group and CPAP group in AHI, MSaO₂, AI, sleep efficiency,N1,N2,SWS and REM percentage of TST and ESS score. The LSaO₂ and average machine time in CPAP assisted MOA group were significantly greater than that in CPAP group (P<0.05), but 90% pressure and average air leakage were significantly lower in the CPAP group (P<0.05). Conclusion: The curative effect of CPCR combined with modified oral appliance was better than CPCR or MOA alone in the treatment of severe OSAHS.
- sleep apnea hypopnea syndrome /
- obstructive /
- continuous positive airway pressure /
- modified oral appliance

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