Effect of nasal dilation on the subjective and objective symptoms of sleep in patients with OSAHS
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摘要:
目的 探讨鼻腔扩容术对阻塞型睡眠呼吸暂停低通气综合征（OSAHS）患者睡眠主客观症状的影响，为鼻腔扩容术在OSAHS中应用提供临床依据。 方法 选择56例于我院耳鼻咽喉科行鼻腔扩容术的OSAHS患者为研究对象，比较患者手术前后的多导睡眠监测结果与鼻堵量表、嗜睡量表及鼾声量表评分。 结果 鼻腔扩容术后OSAHS患者睡眠呼吸暂停低通气指数较术前降低（12.3±4.0 vs 6.3±1.7,P<0.05），平均血氧饱和度（80.6%±11.3% vs 88.1%±14.4%）以及最低血氧饱和度（71.2%±10.7%vs 79.8%±13.5%）均增加（P<0.05）；鼾声量表评分（5.7±1.6分 vs 3.2±0.7分）、鼻堵量表评分（8.9±2.0分 vs 2.8±0.7分）及嗜睡量表量表评分（12.1±2.7分 vs 5.6±1.5分）较术前下降（P<0.05）。 结论 鼻腔扩容术在缓解OSAHS患者阻塞性睡眠呼吸暂停的严重程度及改善OSAHS患者睡眠打鼾、鼻堵及白天嗜睡症状方面效果明显，对OSAHS患者的治疗有重要临床意义。 -
关键词:
- 睡眠呼吸暂停低通气综合征 /
- 鼻腔扩容术 /
- 睡眠主客观症状
Abstract:Objective To explore the effect of nasal dilation on the subjective and objective symptoms of sleep in patients with obstructive sleep apnea hypopnea syndrome (OSAHS), and provide clinical basis for the application of nasal cavity expansion in patients with OSAHS. Methods Fifty-six cases adult patients with OSAHS were chosen as objects. The nasal resistance, the results of multiple sleep monitoring (PSG), the snore outcome survey (SOS), the visual analogue scale (VAS) and the epworth sleepy survey (ESS) were compared before and after nasal surgery expansion. Results After nasal dilation, the nasal resistance and apnea hypopnea index (AHI) of OSAHS patients were decreased significantly (P<0.05).The average oxygen saturation and the lowest oxygen saturation were increased significantly (P<0.05). Scores of SOS scale, VAS scale and ESS scale which reflecting the sleep subjective symptoms were decreased significantly (P<0.05). Conclusion Nasal dilation has a curative effect on reducing nasal resistance and alleviating the severity of obstructive sleep apnea in OSAHS patients.It improves sleep subjective symptoms such as sleep snoring nasal blockage and daytime sleepiness. It is significant in the treatment of patients with OSAHS. -
表 1 患者一般资料（
$\bar x \pm s$ ）分组 例数 年龄（岁） 术前BMI（kg/m2） 术后BMI（kg/m2） 男性 39 46.7±11.9 29.72±2.97 28.41±3.02* 女性 17 51.3±7.6 28.68±2.87 28.39±3.14* 全部 56 48.1±11.2 29.40±2.94 28.40±3.07* *P>0.05vs术前BMI. 
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表 2 手术前后患者PSG监测结果比较（
$\bar x \pm s$ ）监测时间 最低血氧饱和度（%） 平均血氧饱和度（%） AHI指数（次/h） 术前 71.2±10.7 80.6±11.3 12.3±4.0 术后6月 79.8±13.5 88.1±14.4 6.3±1.7 t –3.736 –3.006 10.331 P <0.05 <0.05 <0.05
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表 3 手术前后患者睡眠主观症状的比较（
$\bar x \pm s$ ，分）监测时间 嗜睡量表 鼻堵量表 打鼾量表 术前 12.1±2.7 8.9±2.0 5.7±1.6 术后6月 5.6±1.5 2.8±0.7 3.2±0.7 t 15.748 21.543 10.712 P <0.05 <0.05 <0.05
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