无创正压通气在OSAHS中的应用效果及其对远期生活质量影响

目的探讨无创正压通气（NPPV）在阻塞性睡眠呼吸暂停低通气综合征（OSAHS）中的应用效果及其对患者远期生活质量的影响。方法选取162例OSAHS患者,随机分为治疗组和对照组,每组各81例,两组均予常规治疗,在此基础上治疗组予NPPV治疗、对照组则予常规吸氧治疗。一疗程30 d,两组均治疗2个疗程。观察并比较治疗前、后两组患者的临床症状改善情况、多导睡眠监测、血糖、血脂和凝血指标监测结果。治疗后半年随访,比较两组患者的远期生活质量评分。结果治疗后,治疗组OSAHS患者除晨起咽痛外的各项临床症状均比治疗前及对照组明显改善（P均〈0.05）;其呼吸暂停低通气指数（AHI）均明显下降,平均及最低SaO2均明显上升,与治疗前及对照组比较差异均有统计意义（P均〈0.01）;其血脂、血糖和凝血等指标均比治疗前及对照组明显改善（P均〈0.01）。治疗后半年,对两组患者生活质量进行问卷随访,所有患者均成功随访,无脱落病例。治疗组患者各项生活质量评分均高于对照组（P均〈0.01）。结论 NPPV能明显改善OSAHS患者的临床症状、控制易引起心脑血管缺血性事件的高危因素（血糖、血脂和血栓形成）,提高患者远期生活质量。

Application of noninvasive positive pressure ventilation and effect on long-term quality of life in OSAHS patients

Objective To investigate the application value of noninvasive positive pressure ventilation（ NPPV） in treatment of obstructive sleep apnea hypopnea syndrome（ OSAHS） and influence upon patients＇ long-term quality of life. Methods A total of 162 OSAHS patients were randomly assigned into the treatment and control groups,81 for each. All subjects received conventional treatment. Patients in the treatment group were further treated with NPPV and those in the control group received conventional oxygen inhalation. One course of treatment endured for 30 d and two courses of treatment were delivered in both groups. The improvement of clinical symptoms was observed and the outcomes of polysomnography,blood glucose and lipid and coagulation index were compared before and after treatment between both groups. During subsequent 6-month follow-up,the grading of long-term quality of life was compared between two groups. Results Following corresponding treatment,all clinical symptoms except pharyngalgia occurring in the morning in the treatment group were significantly improved compared with those of the control group（ all P〈0. 05）. In addition,apnea hypopnea index（ AHI） was significantly decreased and mean and minimum SaO2 were significantly increased than pre-treatment values and the control group（ all P〈0. 01）. The indexes including blood lipid,blood glucose and coagulation were equally significantly improved compared with before treatment and the control group（ all P〈0.01）. In the 6th months after treatment,all of the patients in two groups completed the questionnaires regarding quality of life. All patients were successfully followed up. The grading of each index related to quality of life in the treatment group was significantly higher than that in the control group（ all P〈0. 01）.Conclusion NPPV could significantly alleviate the clinical symptoms of OSAHS patients,control the high-risk factors potentially inducing cardiocerebral vascular ischemic events（ blood glucose,blood lipid and