经鼻持续气道内正压通气与咽手术治疗阻塞性睡眠呼吸暂停综合征对比观察

目的对比观察经鼻持续气道内正压通气（ＣＰＡＰ）与悬雍垂腭咽成形术（ＵＰＰＰ）治疗阻塞性睡眠呼吸暂停综合征（ＯＳＡＳ）的疗效及对睡眠呼吸参数的影响，评价二者在ＯＳＡＳ治疗中的地位。方法６０例ＯＳＡＳ患者，ＣＰＡＰ治疗组３６例，手术治疗组２４例。治疗前后作整夜多导睡眠图（ＰＳＧ）监测。结果两组呼吸紊乱指数减少，夜间低氧血症改善，ＣＰＡＰ组患者优于手术组（Ｐ＜０．０１）。有效率ＣＰＡＰ组为９７％，手术组为４６％（Ｐ＜０．０１），最长暂停时间ＣＰＡＰ组缩短，手术组改变不显著，１０例延长。结论ＣＰＡＰ疗效肯定，优于ＵＰＰＰ，适应证广，可作为ＯＳＡＳ首选治疗

Comparison of continuous positive airway pressure (CPAP) with uvulopalatopharyngoplasty in the treatment of obstructive sleep apnea syndrome

OBJECTIVE: To compare the efficacy, side effects, and effects on parameters of sleep of continuous positive airway pressure (CPAP) and uvulopalatopharyngoplasty (UPPP) therapy in OSAS and evaluate their role in the treatment of OSAS. METHOD: 60 patients with OSAS were studied, 36 patients treated with CPAP, 24 patients with UPPP, and the parameters of polysomnography (PSG) obtained before and after treatment were analysed. RESULT: Respiratory disturbance index and sleep hypoxemia were improved significantly in both groups, but the CPAP group was better than UPPP group (P < 0.01). The efficacy was 97% in CPAP and 46% in UPPP group (P < 0.01). The longest apnea duration shortened in CPAP group (from 89 +/- 46 to 39 +/- 19) but there was no difference in UPPP (from 76 +/- 26 to 62 +/- 30) group. The apnea duration in 10 patients was lengthened. CONCLUSION: The effects of UPPP in OSAS were limited. CPAP was more effective than UPPP. CPAP may be indicated as the first choice in the treatment of OSAS.