本文選題：睡眠呼吸暫停低通氣綜合征 + 阻塞性��； 參考：《臨床耳鼻咽喉頭頸外科雜志》2017年12期

【摘要】：目的:比較OSAHS患者清醒和睡眠狀態(tài)時上氣道阻塞情況的VOTE評分。方法:經(jīng)多導(dǎo)睡眠監(jiān)測診斷為OSAHS的患者40例,分別進(jìn)行清醒時Müller's檢查及藥物誘導(dǎo)睡眠內(nèi)鏡檢查(DISE),并錄像記錄檢查結(jié)果。統(tǒng)一使用VOTE評分系統(tǒng)描述檢查過程中所觀察到上氣道的阻塞平面、阻塞程度及阻塞形態(tài),比較兩種檢查結(jié)果的差異,并比較不同阻塞程度的患者間BMI、AHI、最低血氧飽和度及平均血氧飽和度是否存在差異。結(jié)果:清醒狀態(tài)的Müller's檢查主要觀察到腭咽平面及口咽側(cè)壁平面的阻塞,完全阻塞率分別為52.5%和30.0%。DISE結(jié)果提示40例OSAHS患者主要的上氣道阻塞部位仍在腭咽平面,以完全阻塞為主(90.0%),其中以環(huán)形阻塞(95.0%)最為常見�？谘蕚�(cè)壁完全阻塞率為60.0%,舌根完全阻塞率為17.5%。根據(jù)VOTE評分,40例患者DISE檢查在腭咽、口咽側(cè)壁、舌根及會厭平面上的得分均高于清醒狀態(tài)的Müller's檢查,均差異有統(tǒng)計學(xué)意義(P0.05)。Müller's檢查中,各平面不同阻塞程度患者間的BMI、AHI、最低血氧飽和度及平均血氧飽和度均無統(tǒng)計學(xué)差異(P0.05)。DISE檢查結(jié)果中,腭咽平面,部分阻塞患者與完全阻塞患者的AHI值及最低血氧飽和度差異有統(tǒng)計學(xué)意義(P0.05);口咽側(cè)壁、舌根及會厭平面,不同阻塞程度的患者間上述指標(biāo)均無統(tǒng)計學(xué)差異(P0.05)。結(jié)論:OSAHS患者DISE檢查VOTE評分明顯高于Müller's檢查,睡眠狀態(tài)的上氣道阻塞平面更多,阻塞程度更重。BMI、AHI、最低血氧飽和度及平均血氧飽和度與VOTE評分中的阻塞嚴(yán)重程度關(guān)聯(lián)不明顯。
[Abstract]:Objective: to compare the VOTE score of upper airway obstruction in patients with OSAHS. Methods: forty patients with OSAHS diagnosed by polysomnography were examined with M 眉 ller's and DISEN respectively, and the results were recorded by video recording. VOTE scoring system was used to describe the obstruction plane, degree and shape of the upper airway, and the difference between the two results was compared. The differences of BMIAHI, minimum oxygen saturation and mean oxygen saturation between patients with different degrees of obstruction were compared. Results: M 眉 ller's in awake state mainly observed the obstruction of palatopharynx plane and oropharynx lateral wall plane. The complete obstruction rate was 52.5% and 30.0.DISE respectively. The results showed that the main upper airway obstruction site of 40 patients was still in the palatopharynx level. The most common is complete obstruction (90.0%) and annular obstruction (95.0%). The complete obstruction rate of lateral wall of oropharynx and tongue root was 60. 0 and 17. 5% respectively. According to the score of VOTE, the scores of dis in palatopharynx, lateral wall of oropharynx, tongue root and epiglottis were higher than those in M 眉 ller's in awake state. The difference was statistically significant in the examination of palatopharynx, lateral wall of oropharynx, root of tongue and ller's of epiglottis. There was no significant difference in BMIAHI, minimum oxygen saturation and mean oxygen saturation among patients with different degrees of obstruction at different levels. The palatopharynx level was found in the results of P0.05U .DISE. There was significant difference in AHI value and minimum oxygen saturation between patients with partial obstruction and those with complete obstruction (P 0.05), but there was no significant difference between patients with oropharynx lateral wall, tongue root, epiglottis level and different degree of obstruction. Conclusion the score of VOTE in the patients with OSAHS was significantly higher than that in M 眉 ller's. The obstructive level of upper airway was higher and the degree of obstruction was more severe in sleep. The lowest oxygen saturation and mean oxygen saturation were not correlated with the severity of occlusion in VOTE score.
【作者單位】： 南方醫(yī)科大學(xué)南方醫(yī)院耳鼻咽喉科;
【基金】：廣東省自然科學(xué)基金博士啟動項目(No:2015A030310049)
【分類號】：R766
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本文編號：2003364