单纯鼻部手术对伴有鼻阻的阻塞性睡眠呼吸暂停低通气综合征患者睡眠的影响

目的 探讨对伴有鼻阻塞的阻塞性睡眠呼吸暂停低通气综合征(OSAHS)患者，仅单纯行鼻部手术，术后对患者睡眠质量、结构、体位及紊乱性睡眠呼吸(SDB)的影响。方法 对鼻阻塞OSAHS患者30例鼻部手术前后，进行多导睡眠仪(PSG)监测和Epworth嗜睡量表(ESS)评分，比较手术前后睡眠质量、结构、体位和SDS变化。结果 睡眠效率［(86.4±6.4)% ～ (89.4±6.8)%, P＝0.043］、ESS评分(10.08±3.3 ～ 8.1±3.3, P=0.001)和睡眠R期［(15.5±4.0)%～(18.8±4.7)%, P＝0.006］手术后有明显改变。觉醒指数(ArI)、其他睡眠期、侧卧位占睡眠时间比例、呼吸暂停低通气指数(AHI)、最低血氧饱和度(LSaO2)和鼾声术后差异无统计学意义。结论 单纯鼻腔手术可部分改善睡眠质量和结构，但对体位、鼾声和阻塞性睡眠呼吸暂停无影响。

Effectiveness of nasal surgery on sleep in patients with obstructive sleep apnea hypopnea syndrome and nasal obstruction

Objective To evaluate the effectiveness of nasal surgery on sleep quality, architecture, position, and sleep-disordered breathing (SDB) in the patients with obstructive sleep apnea-hypopnea syndrome (OSAHS) and nasal obstruction. Methods 30 patients with OSAHS and nasal obstruction, who underwent the nasal surgery, were enrolled in the study. Polysomnographic(PSG) data and Epworth Sleepiness Scale(ESS) evaluation were performed, and the relationship with sleep quality (sleep efficiency ［SE］ and arousal index ［ArI］), sleep architecture, the distribution of sleep positions, and SDB (apnea-hypopnea index ［AHI］, minimum arterial oxygen saturation ［LSaO2］, and snoring) before and after nasal surgery were analyzed. Results After the nasal surgery, sleep efficiency ［from (86.4±6.4)% to (89.4±6.8)%, P＝0.043］, ESS evaluation (from 10.08±3.3 to 8.1±3.3, P=0.001) and stage R ［from (15.5±4.0)% to (18.8±4.7)%, P＝0.006］ were significantly changed, however, there was no significant change in ArI, other sleep stages, the proportion of sleep time spent in the supine position, AHI, LSaO2 or snoring. Conclusion Nasal surgery alone is partially effective in improving sleep quality and architecture, but it shows no effect on the distribution of sleep positions, snoring and obstructive apnea in patients with OSAHS and nasal obstruction.