应用羟甲唑啉鼻喷剂观察鼻阻塞对阻塞性睡眠呼吸暂停低通气综合征患者的影响

目的探讨羟甲唑啉鼻喷剂对伴鼻阻塞的阻塞性睡眠呼吸暂停低通气综合征（OSAHS）患者的影响,明确鼻阻塞在OSAHS发病中的意义。方法 53例存在鼻阻塞性病变的OSAHS患者,采用鼻声反射比较羟甲唑啉喷雾鼻腔前、后的差异性,PSG监测比较羟甲唑啉喷雾鼻腔前、后的主要指标差异。结果伴鼻阻塞的OSAHS患者羟甲唑啉喷雾鼻腔前、后鼻声反射检测指标：鼻腔最小横截面积（nasal minimal cross-sectional area,NMCA）和鼻阻力（nasal airway resistance,NAR）,包括NMCA（L）、NMCA（R）、NAR（L）、NAR（R）,差异有显著统计学意义,PSG监测指标中最长呼吸暂停时间、平均脉搏血氧饱和度差异有统计学意义,AHI、最低动脉血氧饱和度差异无统计学意义。结论羟甲唑啉鼻喷剂对伴鼻阻塞的OSAHS患者有一定疗效,证实鼻阻塞在OSAHS发病中起一定作用;对存在鼻阻塞性病变的OSAHS患者,鼻通气手术应纳入整个OSAHS治疗计划中。

Oxymetazoline nasal spray in treatment of obstructive sleep apnea-hypopnea syndrome with nasal obstruction

OBJECTIVE To evaluate the effect of oxymetazoline nasal spray on treatment of obstructive sleep apnea-hypopnea syndrome（OSAHS）with nasal obstruction.METHODS Clinical data of 53 patients suffered from OSAHS with nasal obstruction were studied prospectively.The differences of acoustic rhinometry and the changes of polysomnography（PSG）before and after oxymetazoline treatment were observed.RESULTS The differences of NMCA and NAR were significant before and after oxymetazoline therapy.According to the results of PSG,there was a significant increase in the average oxygen saturation levels,a signifcant decrease in the maximum apnea time,but the lowest oxygen saturation levels and apnea-hypopnea index（AHI）were not changed signifcantly.CONCLUSION Oxymetazoline nasal spray has a partly effcacy in treatment of OSAHS with nasal obstruction.Correction of the obstructed nasal airway should certainly be included in the overall treatment for OSAHS.