摘要
目的 应用电子纤维鼻咽镜技术评估阻塞性睡眠呼吸暂停低通气综合征（OSAHS）患者的上气道顺应性.方法 收集在金华市中心医院2014年5月至2015年12月就诊的OSAHS患者93例,应用微动敏感床垫睡眠监测系统（MSMSMS）进行检测,记录患者的病程、体质量指数（BMI）、睡眠呼吸暂停指数（AHI）、平均血氧饱和度.依据MSMSMS进行分级：轻度组32例,中度组31例,重度组30例.所有患者进行电子鼻咽镜检查,并结合Müller试验.通过软件分别计算患者软腭区、舌后、会厌后区的塌陷度.应用SPSS 15.0统计软件分析结果.结果 中度组与轻度组[（4.93±2.91）年比（8.91±4.87）年]以及中度组与重度组[（4.93±2.91）年比（9.27±4.75）年]的病程差异有统计学意义（t=-3.97,P=0.001;t=-4.33,P=0.000）;三组患者AHI的两两组间比较[（7.75±2.49）次,（23.24±3.74）次,（53.27±13.59）次]差异均有统计学意义（t=15.49,P=0.000;t=-45.52,P=0.000;t=-30.02,P=0.000）;轻度组与重度组[（94.25±1.11）％ 比（94.45±0.72）％]及中度组与重度组[（94.45±0.72）％ 比（91.40±3.17）％]的平均氧饱和度差异有统计学意义（t=2.85,P=0.000;t=3.05,P=0.000）.在重度患者中,平均血氧饱和度存在正相关（r=0.45,P=0.007）.软腭区塌陷度三组患者两两组间比较[（74.91±5.30）％,（78.65±4.02）％,（83.30±4.92）％]差异均有统计学意义（t=3.74,P=0.005;t=-8.39,P=0.000;t=-4.65,P=0.001）;舌后区塌陷度中度组与轻度组[（72.65±1.56）％ 比（66.69±8.64）％]及轻度组与重度组[（66.69±8.64）％ 比（74.33±10.96）％]差异均有统计学意义（t=5.96,P=0.008;t=-7.65,P=0.001）,中度组与重度组差异无统计学意义;会厌后区塌陷度轻度组与中度组[（63.84±8.81）％ 比（75.06±5.07）％]及轻度组与重度组[（63.84±8.81）％ 比（76.40±7.94）％]差异均有统计学意义（t=11.22,P=0.000;t=-12.56,P=0.000）,中度组与重度组差异无统计学意义.结论 电子鼻咽镜技术结合Müller试验能够较好地反映基于MSMSMS检测病情分级的OSAHS患者的上气道顺应性,值得在临床上推广运用.
Objective To investigate the application of fiberoscope on upper airway compliance in OSAHS patients with MSMSMS. Methods From May 2014 to December 2015,93 patients with OSAHS in Jinhua Central Hospital were detected by MSMSMS[including 32 mild cases （MI）,31 moderate cases （MO）,and 30 severe cases （SE）] underwent electronic nasopharyngeal examination combined with the Muller test. The course of 93 OSAHS patients were recorded,including body mass index （BMI）,sleep apnea index （AHI）,mean oxygen saturation. The degree of collapse in the patients＇ soft palate area,tongue,epiglottis after area were calculated by the software. The results were analyzed by SPSS15. 0 statistical software. Results The disease courses between the mild group and moderate group [（4. 93 ± 2. 91）years,（8. 91 ± 4. 87）years],as well as between the moderate group and severe group [（4. 93 ± 2. 91）years,（9. 27 ± 4. 75） years],had statistically significant differences （t = - 3. 97,P = 0. 001;t =- 4. 33,P 0. 05）. There were statistically significant differences between the mild group and moderate group[（63. 84 ± 8. 81）％ vs. （75. 06 ± 5. 07）％ ],the mild group and severe group[（63. 84 ± 8. 81）％ vs. （76. 40 ± 7. 94）]in the collapse of epiglottic area （t = 11. 22,P = 0. 000;t = - 12. 56,P = 0. 000）. There was no statistically significant difference between the moderate group and severe group in the collapse of epiglottic area（P 〉 0. 05）. Conclusion Fiberoscope combined with Müller test can respond better upper airway compliance in OSAHS patients with MSMSMS. It is worth to promote in clinic.
作者
邵科峰
王翰青
诸葛盼
Shao Kefeng;Wang Hanqing;Zhuge Pan(Department of Ear-Nose-Throat,Jinhua Central Hospital,Jinhna,Zhejiang 321000,China)
出处
《中国基层医药》
CAS
2018年第22期2912-2916,共5页
Chinese Journal of Primary Medicine and Pharmacy
基金
浙江省金华市科技局重点项目（2014-3-004）
