Epworth嗜睡评分对评价老年患者OSAHS严重程度的价值

目的了解Epworth嗜睡量表评分(ESS)对老年患者阻塞性睡眠呼吸暂停低通气综合征(OS-AHS)严重程度分级的意义。方法对打鼾、睡眠憋醒行多导睡眠图检查的患者1361例进行回顾性分析,了解患者的嗜睡情况,进行嗜睡评分分析。结果老年OSAHS患者的Epworth嗜睡评分明显高于非OSAHS者。单因素分析显示:老年组睡眠呼吸暂停低通气指数(AHI)与嗜睡评分、颈围、腰围、打鼾家族史、悬雍垂大、体重相关。在控制了体重、悬雍垂肿大、小颌畸形后的多分类反应变量的Logistic回归分析显示,AHI与嗜睡评分相关。结论老年人的AHI与ESS之间存在相关性,ESS可以应用于老年人OSAHS的初筛及病情严重程度的评价。     

绝经期女性阻塞性睡眠呼吸暂停综合征患者的多导睡眠图监测

阻塞性睡眠呼吸暂停（OSAS）是以夜间睡眠时反复发作的严重打鼾、呼吸暂停、白天嗜睡等为特征的一种综合征。为探讨绝经期女性OSAS多导睡眠图（PSG）特点，随机收集2004年3月至2005年12月在本院睡眠呼吸疾病诊疗中心经PSG监测的绝经期女性病人53例，现报告如下。     

阻塞性睡眠呼吸暂停低通气综合征患者的初筛及其意义

目的 对阻塞性睡眠呼吸暂停低通气综合征患者（OSAHS）利用睡眠问卷调查表进行初筛，初步判断是否有阻塞性睡眠呼吸暂停低通气综合征。方法利用睡眠问卷调查表其中包括嗜睡评估表（ESS）问卷调查及判断嗜睡评分（Ep）、睡眠中不适项，BMI[（体重）Kg^2／（身高）m^2]等指标对患者进行初步判断，再进行多导睡眠监测（PSG）进行检查确诊。结果睡眠问卷调查表对睡眠呼吸暂停综合征的患者初筛有效率高、准确、可靠。可用于临床患者及其大型体检时进行初筛。     

睡眠呼吸暂停综合征病人夜间监测的护理

[目的]探讨睡眠呼吸暂停综合征监测的护理措施。[方法]回顾性分析62例潜在睡眠呼吸障碍病人采用多导睡眠仪进行夜间监测的临床资料。[结果]本组监测显示,单纯打鼾6例,阻塞性睡眠呼吸暂停综合征37例,中枢性睡眠呼吸暂停综合征1例,混合性睡眠呼吸暂停综合征（低通气与阻塞性）16例,2例因监测中病情变化终止监测,转送病房治疗后康复出院。[结论]加强睡眠呼吸暂停综合征夜间监测的护理是减少睡眠呼吸暂停综合征病人危险因素及顺利完成监测的重要措施。     

精神障碍伴阻塞性睡眠呼吸暂停综合征 患者的睡眠生理研究

目的 探讨精神障碍伴发阻塞性睡眠呼吸暂停综合征 (obstructive sleep apnea syndrome,OSAS)患者的临床特点及睡眠生理改变。方法 对 420例精神障碍患者进行多导睡眠图 (PSG)检测。将检出的 18例 OSAS与无 OSAS的精神病患者进行比较。 结果 OSAS组打鼾、睡眠憋醒、白天嗜睡、记忆减退症状较无 OSAS组明显增多 (P     

阻塞性睡眠呼吸暂停低通气综合征与冠心病严重程度关系的研究

[目的]探讨阻塞性睡眠呼吸暂停综合征(OSAS)与冠脉病变严重程度及心功能的相关性.[方法]87例冠心病患者依据冠状动脉造影(CAG)及多导睡眠仪监测分为对照组21例,轻度OSAS组34例,中度OSAS组15例,重度OSAS组17例,分别测患者呼吸暂停低通气指数(AHI)、Gensini评分及脑钠肽(BNP).[结果]...     

血氧气流记录与多导睡眠图的应用比较

目的:研究和评价血氧气流记录仪诊断不同程度阻塞性睡眠呼吸暂停低通气综合征的准确性。方法:62例研究对象同时进行整夜标准多导睡眠和血氧气流记录监测,以标准多导睡眠图监测的呼吸暂停低通气指数为诊断阻塞性睡眠呼吸暂停低通气综合征的金标准,评估血氧气流记录监测呼吸暂停低通气指数和最低血氧饱和度的准确性。结果:血氧气流记录与标准多导睡眠图测得的呼吸暂停低通气指数和最低血氧饱和度密切相关(r=0.964和0.816,P=0.000)。以呼吸暂停低通气指数≥5为诊断界值,血氧气流记录与标准多导睡眠图比较诊断阻塞性睡眠呼吸暂停低通气综合征的灵敏度为93.3%,特异度为76.5%。正常和轻度阻塞性睡眠呼吸暂停低通气综合征组血氧气流记录-呼吸暂停低通气指数与标准多导睡眠图-呼吸暂停低通气指数差异无统计学意义(P>0.05),中重度阻塞性睡眠呼吸暂停低通气综合征组血氧气流记录-呼吸暂停低通气指数较标准多导睡眠图-呼吸暂停低通气指数减低(P<0.05)。不同严重程度阻塞性睡眠呼吸暂停低通气综合征组血氧气流记录-最低血氧饱和度与标准多导睡眠图-最低血氧饱和度差异无统计学意义(P>0.05)。结论:血氧气流记录具有诊断阻塞性睡眠呼吸暂停低通气综合征的能力,可用于阻塞性睡眠呼吸暂停低通气综合征的初步诊断;血氧气流记录在评价中重度阻塞性睡眠呼吸暂停低通气综合征时可能低估病情,不宜单独用于判断阻塞性睡眠呼吸暂停低通气综合征的严重程度。     

睡眠呼吸暂停综合征病人夜间监测的护理

[目的]探讨睡眠呼吸暂停综合征监测的护理措施.[方法]回顾性分析62例潜在睡眠呼吸障碍病人采用多导睡眠仪进行夜间监测的临床资料.[结果]本组监测显示,单纯打鼾6例,阻塞性睡眠呼吸暂停综合征37例,中枢性睡眠呼吸暂停综合征1例,混合性睡眠呼吸暂停综合征(低通气与阻塞性)16例,2例因监测中病情变化终止监测,转送病房治疗后康复出院.[结论]加强睡眠呼吸暂停综合征夜间监测的护理是减少睡眠呼吸暂停综合征病人危险因素及顺利完成监测的重要措施.     

OSA-18联合PM对儿童OSAS的诊断价值

目的探讨特异性生活质量调查表(OSA-18)联合家庭便携式睡眠监测(PM)对儿童阻塞性睡眠呼吸暂停综合征(OSAS)的诊断价值。方法选取2018年4～7月以睡眠打鼾或/和张口呼吸为主要症状就诊于我科门诊的患儿41例,家属填写OSA-18并行家庭便携式睡眠监测(PM),于5d内行整夜多导睡眠监测(PSG),根据呼吸暂停低通气指数(AHI)将患儿分为单纯打鼾组5例、OSAS组36例(轻度OSAS组12例、重度OSAS组18例、重度OSAS组6例)。比较两组及不同程度OSAS患儿的OSA-18各维度评分、总评分、AHI、呼吸紊乱指数(RDI)的相关性。结果单纯鼾症组OSA-18各维度评分、总评分、RDI及AHI低于OSAS组,差异有统计学意义(P0.05);三组不同程度OSAS组的OSA-18各维度评分、总评分、RDI及AHI比较,差异有统计学意义(P0.05); OSA-18评分、RDI与AHI均呈相关性(P0.05)。结论 OSA-18联合家庭便携式睡眠监测在儿童睡眠呼吸暂停综合征的诊断中具有较高的价值,而且儿童配合度高,值得推广。     

使用持续气道正压通气依从性的影响因素及干预进展

阻塞性睡眠呼吸暂停综合征(obstructive sleep apnea syndrome,OSAS),是一种潜在致死性疾病[1]。其主要表现为睡眠呼吸暂停、夜间觉醒、打鼾、白天困倦、不可抑制性嗜睡、晨起头痛、记忆力下降、反应迟钝等症状。病情长期发展可出现高血压、     

青光眼病人的睡眠状况调查及其影响因素

[目的]了解青光眼病人睡眠状况及其影响因素。[方法]选取131例原发性青光眼住院病人,采用自行设计问卷,对其睡眠状况、影响因素及术后不良反应发生情况进行调查。[结果]90.8%青光眼病人存在入睡困难,93.1%病人睡眠不深。情绪不稳定、焦虑、恐惧等不良心理是影响青光眼病人睡眠的主要因素。[结论]住院青光眼病人存在睡眠质量问题,心理因素是其主要的影响因素。     

Disorders of glucose metabolism and insulin resistance in patients with obstructive sleep apnoea syndrome

Objective: Insulin resistance (IR) and disorders of glucose metabolism (DGM) are risk factors for cardiovascular diseases. There are different reasons for development of DGM in patients with obstructive sleep apnoea syndrome (OSAS) and this association is controversial. We investigated the frequency of DGM and IR in patients with OSAS and determining factors for these disorders. Method: One hundred and twelve untreated patients with OSAS and 19 non‐apnoeic snoring subjects upon polysomnography were included in this study. Oral glucose tolerance test (OGTT) was performed in all subjects who had fasting blood glucose < 125 mg/dl. IR method was analysed using homeostasis assessment model (HOMA‐IR). Diabetes mellitus (DM), impaired glucose tolerance (IGT) and impaired fasting glucose (IFG) were defined according to values of OGTT. DGM was defined as having one of the diagnoses of DM, IGT or IFG. Subjective sleepiness of all subjects was assessed with Epworth Sleepiness Scale (ESS). Excessive daytime sleepiness (EDS) was described as ESS score ≥ 10. Results: Fasting glucose and the rate of DGM in patients with OSAS were higher than in non‐apnoeic snoring subjects. DGM were shown in % 15.7 of non‐apnoeic snoring subjects, 29.6% of mild sleep apnoea, 50% of moderate sleep apnoea and 61.8% of severe sleep apnoea. The rate of DGM in patients with moderate and severe OSAS was higher than in non‐apnoeic snoring subjects and in patients with severe OSAS higher than in patients with mild OSAS. DGM are associated with body mass index (BMI), severity of OSAS, arousal index and EDS. In addition, IR is associated with apnoea hypopnoea index, BMI, arousal index and ESS score. Conclusion: Obstructive sleep apnoea syndrome is associated with high frequency of DGM. In addition, the progression of disease from simple snoring and mild OSAS to severe OSAS increases the rate of DGM. Thus, DGM especially in patients with severe OSAS should be examined in regular periods.     

塔里木盆地玛南地区奥陶系鹰山组串珠特征及勘探前景

目的 探讨延续护理对阻塞性睡眠呼吸暂停综合征患者生存质量的影响.方法 将61例阻塞性睡眠呼吸暂停综合征出院患者按随机数字表分为对照组30例和观察组31例,对照组予常规出院指导及定期门诊随访,观察组在常规出院指导基础上实施延续护理.分别在患者出院后3月、6月用Epworth嗜睡评价量表、睡眠紊乱指数及特异性健康相关生存质量问卷评价患者的生存质量,出院后3月比较两组患者呼吸机使用依从性.结果 观察组患者Epworth嗜睡评分、睡眠紊乱指数评分低于对照组,两组评分比较有统计学意义（P＜0.05）;观察组生存质量问卷各维度评分高于对照组,两组评分比较有统计学意义（P＜0.05）;呼吸机使用依从率观察组96.8%、对照组56.7%,两组比较,x2=13.641,P＜0.05.结论 延续护理可提高阻塞性睡眠呼吸暂停综合征患者的生存质量.     

维持性血液透析病人睡眠状况调查分析

目的了解维持性血液透析病人的睡眠状况及其影响因素,为提供针对性干预措施提供依据。方法采用睡眠状况自评量表(Self-RatingSleepingScale,SRSS)对72例维持性血液透析住院病人进行问卷调查。结果70.8%的维持性血液透析病人存在不同程度的失眠,高于全国常模,差异有统计学意义(P<0.01)。维持性血液透析病人存在的睡眠问题主要为失眠后反应、睡眠质量差、睡眠不稳。由病理因素所致的严重躯体症状、心理压力以及睡眠颠倒是导致病人失眠的最主要因素。结论维持性血液透析病人失眠具有普遍性、特殊性,应引起医护人员的足够重视。     

慢性肝病病人的睡眠状况研究

[目的]研究慢性肝病病人睡眠状况。[方法]采用睡眠状况自评量表(SRSS)对197例慢性肝病病人的睡眠状况进行调查。[结果]慢性肝病病人睡眠状况自评总分显著高于常模及内科住院病人(P<0.01),中度、重度睡眠障碍发生率是常模的3倍多。其中10个因子中有7个得分明显高于常模。睡眠时间、入睡困难、睡眠不稳及早醒是反映慢性肝病病人睡眠状况的主要因子。年龄对睡眠状况有影响。[结论]慢性肝病病人睡眠障碍发生率高,程度严重,病人年龄对睡眠质量有一定的影响。     

心理社会应激因素与癌症患者睡眠质量的相关性

目的：探讨心理社会应激有关因素与癌症患者睡眠状况的关系。方法：对168名癌症患者进行问卷调查，包括睡眠状况评定，医学应对问卷（MCMQ）、特质应对条目（TCI）、心身症状自评量表（SCL－90）、自编心理社会因素问卷，并用SPSS作相关／回归分析，结果：癌症患者TCI中的消极应对、MCMQ中的屈服应时，心身症状和其它多项心理社会因素与睡眠状况均有相关性；多元回归分析显示，心理健康水平，情感表达，屈服应对，食欲，体质等心理应激有关因素是影响癌症患者睡眠的主要因素，结论：心理应激有关因素对癌症患者睡眠质量有重要影响。     

心理干预对骨肉瘤患者术后睡眠的影响

目的:探讨心理干预对骨肉瘤患者术后睡眠质量的影响。方法:对32例骨肉瘤术后患者采取心理干预,包括:认知干预、控制睡眠行为、传授放松训练技术等,干预前后分别对抑郁自评量表、焦虑自评量表、睡眠效率值进行比较。结果:本组32例患者干预后睡眠效率值明显高于干预前(P0.01)。干预后抑郁自评量表和焦虑自评量表评分均低于干预前(P0.05,P0.01)。说明干预后患者的睡眠和心理状况明显改善。结论:心理干预可提高骨肉瘤患者术后睡眠效率,改善患者的心理健康,形成良性的心理环境,促进患者术后康复。     

Dependence of severity of obstructive sleep apnoea syndrome on body mass gain in patients after emergence of snoring symptom

AIM: To search for simple clinical criteria for prediction of obstructive sleep apnoea syndrome (OSAS). MATERIAL AND METHODS: Case histories of 389 patients with uncomplicated snoring and OSAS (321 males and 68 females, mean age 55.2 +/- 10.9 years) were analysed retrospectively. The OSAS diagnosis was made according to polysomnographic evidence using somnological systems Minisimno (Sefam, France) and Compumedix S-series (Compumedix, Australia). Correlations between OSAS severity and some clinical parameters were studied. RESULTS: It was found that gain in body mass after onset of snoring significantly correlates with apnea/hypopnea index and with OSAS severity. If the body mass gain was > 10 kg, there is a 95% probability of the existence of moderate or severe OSAS. If the gain was > 20 kg, severe OSAS is highly probable. CONCLUSION: Body mass gain after onset of snoring can help in prediction of OSAS severity.     

螺旋CT咽部动态扫描对阻塞性睡眠呼吸暂停综合征的应用

目的:通过对31例阻塞性睡眠呼吸暂停综合征(OSAS)患者、20例健康人的咽部进行螺旋CT扫描,比较两者的上气道截面积,以及比较OSAS患者在清醒与睡眠状态下的上气道截面积,客观评价螺旋CT检查OSAS患者的应用价值。材料和方法:螺旋CT在扫描咽部后,用螺旋CT的随机软件对上气道进行测量和重建,观测OSAS患者上气道狭窄的部位及狭窄程度。结果:发现OSAS患者的上气道截面积明显小于健康人,且OSAS患者在睡眠状态下上气道截面积进一步缩小甚至闭塞,这种狭窄主要是由于口咽部周围软组织增生及软腭肥厚引起。结论:咽部螺旋CT检查可确定OSAS患者局部狭窄的程度和范围,有助于治疗方案的选择。     

Reasons for sleeping difficulties as perceived by adolescents: a content analysis

Sleeping difficulties are increasingly prevalent among adolescents worldwide and have negative consequences for adolescent health and education. The aim of this study was to describe the reasons for sleeping difficulties as perceived by adolescents. Sleeping difficulties include insufficient sleep, trouble falling asleep, waking up at night or sleep that does not leave an individual rested. Data were collected in 2015 using an open-ended question. The sample consisted of n = 475 adolescents from a city in Sweden, aged 15–16 years, with self-assessed sleeping difficulties. The results described the reasons for the adolescents’ sleeping difficulties, at a general, thematic level, as an imbalance between requirements and preconditions, distributed to stress, technology use, poor sleep habits, existential thoughts, needs and suffering. To find a balance in their daily lives, adolescents may need support from parents, school nurses and school health services to deal with their sleeping difficulties.