诱导睡眠下电子喉镜在阻塞性睡眠呼吸暂停低通气综合征定位诊断中的临床应用

目的:探讨诱导睡眠下电子喉镜在阻塞性睡眠呼吸暂停低通气综合征(OSAHS)定位诊断中的应用价值.方法:将经PSG确诊的132例OSAHS患者随机分成A、B 2组:A组61例为实验组,术前给予咪唑安定诱导睡眠后用电子喉镜对上呼吸道进行动态观察,以确定阻塞部位;B组71例作为对照组,术前清醒状态下行常规上呼吸道检查和电子喉镜检查.所有患者均根据定位诊断结果进行针对性手术治疗.结果:A组存在多部位阻塞者达72.1%,而B组仅为33.8%,2组差异有统计学意义(P＜0.05).患者术后均随访6个月以上,A组总有效率达91.8%,B组仅为64.8%.A、B 2组的治愈率、显效率、总有效率均差异有统计学意义(均P＜0.05).结论:诱导睡眠状态下大部分OSAHS患者上呼吸道存在多部位的解剖性狭窄,术前在诱导睡眠下应用电子喉镜进行OSAHS患者上呼吸道阻塞部位的定位诊断,并据此进行针对性的手术治疗,可以显著提高OSAHS手术治疗的效果.

The value of video laryngoscope in localization diagnosis of upper airway stricture in obstructive sleep apnea-hypopnea syndrome during drug-induced sleep

Objective:To investigate the value of video laryngoscope in localization diagnosis of upper airway stricture in obstructive sleep apnea-hypopnea syndrome(OSAHS)during drug-induced sleep.Method:One hundred and thirty two patients with OSAHS were randomly divided into group A and B in this study.In group A,the patients were examined with video laryngoscope to locate the upper airway stricture under midazolam-induced sleep.In group B,the patients had conventional physical examination and video laryngoscope when awake.And the operation plans of both groups were made based on the localization diagnosis results.Result:In group A,72.1% patients have several stricture levels and in group B only 33.8%.The patients was followed up time more than 6 months,and the cure rate,the excellent effective rate,and the total effective rate of group A were significantly higher than those in group B respectively(P<0.05).Conclusion:Most patients of OSAHS have several stricture levels of upper airway under Midazolam-induced sleep.Localization diagnosis of upper airway stricture in patients with OSAHS with video laryngoscope before operation can improve the cure efficiency significantly.