OSAHS患者上呼吸道阻塞临床评价系统的建立及应用

目的 :探讨建立临床评价阻塞性睡眠呼吸暂停低通气综合征的简易方法 ,综合评价OSAHS患者上呼吸道各部位的阻塞程度 ,以指导手术或器械治疗。方法 :将患者鼻、口咽、舌、喉等各部位定为 0～ 4分 ,综合评价与确定阻塞的程度。结果 :各部位解剖阻塞评分为 3～ 4分者对诊为呼吸暂停有重要意义 ,临床综合评分大于 10分者手术效果好 ,小于 10分者用CPAP治疗为好。结论 :目前OSAHS患者的手术指征及疗效标准仍有争议 ,参考国外制定的临床评价上呼吸道阻塞程度的标准并作了改进 ,可做为睡眠呼吸监测的补充 ,供门诊及无法进行睡眠监测的基层医院使用

The clinical evaluation of the upper respiratory obstruction in obstructive sleep apnea and hypopnea syndrome

Objective:To establish a grading system of upper respiratory obstruction and evaluated the obstruction degree of upper respiratory tract in obstructive sleep apnea and hypopnea syndrome (OSAHS). Method: Different areas of upper respiratory tract including nose oropharynx, root of tongue and larynx were classified into 5 degrees, with score ranging from zero to four points respectively, in which the degree of obstruction can be comprehensively evaluated. Results: The analysis of 37 cases of OSAHS patients indicated that any patient whose obstruction score was 3-4 points can be suggested of OSAHS. The surgery was recommended for those whose clinical obstruction score was over 10 points because of its better therapeutic effect, while CPAP therapy was recommended for those below 10 points. Conclusion:At present, the controversy still exists regarding the surgical indication and criteria for therapeutic effect, therefore, the clinical grading criteria of evaluating obstruction degree for OSAHS formulated abroad is modified according to our clinical practice, which provides easier access to the outpatient department and those small hospitals without sleep monitorig equipment.