OSAHS患者鼻中隔矫正术后经鼻持续气道正压通气的疗效观察

摘要

Objective To determine the effect of nasal septum surgery on nasal- continuous positive airway pressure (nCPAP) in patients with obstructive sleep apnea hypopnea syndrome (OSAHS) and nasal septum devlation. Methods 54 patients with OSAHS and nasal septum deviation underwent the correction of nasal septum in our hospital between January 2011 and December 2014 were studyed. The nasal resistance, CPAP treatment pressure and tolerance to the nCPAP therapy were measured by nasal resistance meter, auto-CPAP respirator and visual analogue score (VAS) before and one month after operation respectively. Results Compared with the preoperative, there were significant lower of nasal resistance and CPAP pressure, but higher of VAS score in three months after operation (P<0.01). The AHI and SaO2 were significantly improved in three months after operation (P<0.01). Pearson correlation analysis showed that, a positive correlation between CPAP pressure and nasal resistance (r=0.39, P<0.01), a negative correlated between VAS score and CPAP pressure(r=-0.46, P<0.01). Conclusion The nasal resistance and treatment pressure of nCPAP were be reduced by correction of nasal septum in patients with OSAHS and nasal septum deviation.%目的 探讨阻CPAP塞性睡眠呼吸暂停低通气综合征(obstructive sleep apnea hypopnea syndrome,OSAHS)患者在接受鼻中隔矫正术后经鼻持续气道正压通气(nasalcontinuous positive airway pressure,nCPAP)治疗耐受性变化.方法 选择2011年1月至2014年12月在我院耳鼻喉科就诊的54例OSAHS合并鼻中隔偏曲患者作为研究对象,分别采用鼻阻力仪、auto-CPAP呼吸机及视觉模拟量表(visual analogue scale,VAS)在鼻中隔矫正术前及术后1个月对鼻通气阻力、CPAP压力及nCPAP治疗耐受性进行测定.结果 术后3个月患者的AHI及最低SaO2均较术前显著改善(P<0.01),鼻气道阻力及适宜CPAP最佳压力较术前显著降低,VAS评分较术前明显提高,差异均有统计学意义(P<0.01).Pearson相关性分析显示,CPAP压力与鼻气道阻力呈正相关(r=0.39,P<0.01);CPAP压力与VAS评分呈负相关(r=-0.46,P<0.01).结论 OSAHS患者接受鼻中隔矫正术能有效降低鼻气道阻力,降低nCPAP治疗压力,提高nCPAP治疗的耐受性.