| 鼻腔扩容术治疗鼻塞伴OSAHS病人的疗效观察 |
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| 引用本文： | 龚为群,何杰平,马兆鑫,阎萍. 鼻腔扩容术治疗鼻塞伴OSAHS病人的疗效观察[J]. 蚌埠医学院学报, 2018, 43(9): 1143-1146. DOI: 10.13898/j.cnki.issn.1000-2200.2018.09.007 |
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| 作者姓名： | 龚为群 何杰平 马兆鑫 阎萍 |
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| 作者单位： | 1. 同济大学附属东方医院 耳鼻咽喉头颈外科, 上海 200120;2. 上海中冶医院 耳鼻咽喉头颈外科, 200941;3. 上海市徐汇区大华医院 耳鼻咽喉科, 200237 |
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| 基金项目： | 上海市卫生计生委科研项目 |
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| 摘 要： | 目的:观察鼻腔扩容术治疗鼻塞伴阻塞性睡眠呼吸暂停低通气综合征（obstructive sleep apnea hypopnea syndrome，OSAHS）病人的疗效，探讨鼻腔结构改变对OSAHS病人睡眠质量及鼻阻力的影响。方法:选取鼻塞并伴有睡眠打鼾病人99例，术前2 h内分别进行视觉模拟量表鼻塞症状评分、匹兹堡睡眠质量指数量表评分、Epworth嗜睡量表（epworth sleepiness scale，ESS）评分和多导睡眠描记图检查及鼻阻力测定；根据监测所得的呼吸暂停低通气指数（apnea hypopnea index，AHI）和最低血氧饱和度（lowest oxygen saturation，LSaO2），将研究对象分为OSAHS轻度病人48例，中度43例，重度8例。全麻下行鼻内镜鼻腔扩容术，随访至术后第6个月，比较手术前后以上指标的变化。结果:手术前后，轻、中度组病人鼻阻力和AHI均明显低于重度组，轻度组均明显低于中度组（P<0.01）；轻度病人的LSaO2均高于中、重度组（P<0.05~P<0.01）。术前轻、中度病人的ESS评分均明显低于重度组（P<0.01），术后3组病人的ESS评分差异无统计学意义（P>0.05）。3组病人术前、术后PSQI评分间差异均无统计学意义（P>0.05）。与手术前比较，手术后3组病人鼻阻力和ESS评分均明显降低（P<0.01）。结论:鼻腔扩容术能明显降低鼻阻力，改善轻、中度OSAHS病人的嗜睡程度，对重度OSAHS病人血氧饱和度有提高。
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| 关 键 词： | 阻塞性睡眠呼吸暂停低通气综合征 鼻腔扩容术 多导睡眠监测 鼻阻力 |
| 收稿时间： | 2018-02-28 |
Effect of nasal cavity expansion surgery in the treatment of nasal obstruction complicated with OSAHS |
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| Affiliation: | 1. Otolaryngology Head and Neck Surgery, Dongfang Hospital Affiliated to Tongji University, Shanghai 200120;2. Otolaryngology Head and Neck Surgery, Shanghai Zhongye Hospital, Shanghai 200941;3. Department of Otolaryngology, Dahua Hospital, Xuhui District, Shanghai 200237, China |
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| Abstract: | Objective:To observe the efficacy of nasal cavity expansion surgery in the treatment of nasal obstruction complicated with obstructive sleep apnea hypopnea syndrome(OSAHS),and explore the effects of nasal structure change on sleep quality and nasal resistance in patients with OSAHS.Methods:The visual analogue scale score for nasal congestion,Pittsburgh sleep quality index(PSQI) scale,Epworth sleepiness scale(ESS),polysomnography(PSG) map and nasal airway resistance in 99 patients with snoring complicated with nasal obstruction were examined before 3 days of operation.The patients were divided into the mild OSAHS group(n=48),moderate OSAHS group(n=43) and severe OSAHS group(n=8) according to the apnea hypopnea index(AHI) and lowest oxygen saturation(LSaO2).All patients were treated with nasal endoscopic expansion,and followed up for 6 months.The index changes between before and after operation among three groups were compared.Results:Before and after operation,the nasal resistance and AHI in mild and moderate OSAHS groups were significantly lower than those in severe OSAHS group,which in mild OSAHS group was significantly lower than that in moderate OSAHS group(P<0.01),and the LSaO2 in mild OSAHS group was higher than that in moderate and severe OSAHS groups(P<0.05 to P<0.01).Before operation,the ESS score in mild and moderate OSAHS groups were significantly lower than that in severe OSAHS group(P<0.01),and the difference of the ESS score among three groups was not statistically significant after operation(P>0.05).The difference of the PSQI score among three groups before and after operation was not statistically significant after operation(P>0.05).Compared with before operation,the scores of the nasal resistance and ESS in three groups significantly decreased after operation(P<0.01).Conclusions:Nasal cavity expansion surgery can significantly decrease the nasal airway resistance,improve the symptom of sleepiness in patients with mild or moderate OSAHS,and improve the LSaO2 of patients with severe OSAHS. |
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