鼻腔结构矫正术治疗OSAHS临床疗效分析

摘要

目的 分析并探讨睡眠呼吸暂停低通气综合征(OSAHS)患者接受鼻腔结构矫正术治疗的临床效果.方法 选取我院56例轻、中度OSAHS患者,接受鼻腔结构矫正术治疗.通过声反射鼻腔(AR)测量、鼻腔阻力(RM)检查评估患者术前和术后6个月0~5cm鼻腔容积(NCV0-5CM)、鼻腔最小横截面积(NMCA)、鼻气道阻力(NAR)值的变化;通过视觉模拟量表(VAS)评估患者鼻塞情况;通过Epworth嗜睡量表(ESS)评估患者嗜睡程度;通过多导睡眠呼吸监测(PSG)评估患者术前和术后6个月睡眠呼吸暂停低通气指数(AHI)和最低血氧饱和度(LSaO2)的变化.结果 所有受试者手术之前NCV0-5CM、NMCA、NAR、VAS评分、ESS评分、AHI、LSaO2分别为(4.71±0.25)cm3、(0.34±0.03)cm2、(0.47±0.02)kPa?s/L、(6.98±1.44)分、(13.76±3.55)分、(9.65± 4.05)次/h、(76.47±12.10)%,手术后随访6个月,复查结果显示患者各项检查指标分别为(8.64±0.79)cm3、(0.60±0.11)cm2、(0.23±0.02)kPa?s/L、(2.57±1.09)分、(6.89±2.04)分、(5.13±2.99)次/h、(82.31±10.94)%,术前和术后检查结果比较,有显著的统计学差异,P<0.05.另外,经spearman秩相关统计分析,ΔVAS和ΔNAR的相关性、ΔESS和ΔAHI的相关性以及ΔESS和ΔLSaO2的相关性均无统计学意义,P>0.05.结论 鼻腔结构矫正术对于治疗轻中度OSAHS患者是具有临床有效性的,值得临床推广.%Objective To analyze and discuss the clinical effect of nasal cavity structure diorthosis on patients with obstructive sleep apnea-hypopnea syndrome (OSAHS). Methods 56 cases with mild to moderate OSAHS in our hospital were treated with nasal cavity structure diorthosis alone.Before and after surgery for 6 months,all volunteers were detected with acoustic rhinometry (AR)and rhinomanometer (RM) for nasal cavity in 0~5cm volume (NCV0-5CM), nasal minimal cross-sectional area (NMCA) and nasal airway resisitance (NAR), evaluated with visual analogue scale (VAS) for the degree of nasal blockage, used Epworth sleepiness score to evaluate the sleepiness of OSAHS patients, monitored with polysomnpgraphy for the sleep apnea and hypopnea index (AHI) and the lowest arterial oxygen saturation (LSaO2).Results The mean values of NCV0-5CM,NMCA,NAR,VAS score,ESS score,AHI,LSaO2 were(4.71±0.25)cm3,(0.34±0.03)cm2,(0.47±0.02)kPa?s/L,(6.98±1.44),(13.76±3.55),(9.65±4.05)/h,(76.47±12.10)% respectively before surgery,while the parameters after surgery 6 months were(8.64±0.79)cm3,(0.60±0.11)cm2,(0.23±0.02)kPa?s/L,(2.57±1.09), (6.89±2.04),(5.13±2.99)/h,(82.31±10.94)% respectively.The difference was statistical significance between the parameters before and after surgery,P<0.05.Besides,by the spearman rank correlation statistical analysis,the ΔVAS and ΔNAR,ΔESS and ΔAHI,ΔESS and ΔLSaO2were with no statistical correlation, P>0.05. Conclusion The nasal cavity structure diorthosis would be effective on the treatment of mild to moderate OSAHS patients,which is worthy to be clinically popularized.