發(fā)布時間：2018-03-19 19:23

  本文選題：阻塞性睡眠呼吸暫停低通氣綜合征　切入點：喉部及下咽部惡性腫瘤　出處：《鄭州大學(xué)》2017年碩士論文　論文類型：學(xué)位論文

【摘要】：背景與目的阻塞性睡眠呼吸暫停綜合征(Obstructive Sleep Apnea Syndrome,OSAS)是一種臨床常見的疾病,遺傳因素、解剖因素、神經(jīng)體液因素、肥胖及其他多種因素均是該病的常見病因。OSAS可引起心腦血管、內(nèi)分泌等多種系統(tǒng)的嚴(yán)重并發(fā)癥,使患者的生活質(zhì)量有所下降,甚至危及生命。OSAS目前已被認(rèn)為是多種全身性疾病的獨(dú)立危險因素。研究已證實OSAS可以促進(jìn)腫瘤的發(fā)生與發(fā)展,并且與頭頸部腫瘤存在一定的關(guān)系。喉癌及下咽癌是常見的頭頸部惡性腫瘤,同時也是耳鼻咽喉科中發(fā)病率較高的惡性腫瘤。據(jù)報道,喉部及下咽部惡性腫瘤患者多數(shù)也存在夜間睡眠障礙、白天嗜睡等癥狀。合并OSAS的頭頸部腫瘤患者術(shù)后并發(fā)癥較高。而經(jīng)過治療后患者體內(nèi)的多種腫瘤相關(guān)基因的表達(dá)均有所下降。由此可見OSAS的有效治療對于腫瘤的預(yù)防和治療有一定的意義。因此該類患者是否合并OSAS應(yīng)盡早得到診斷與治療,從而降低其在腫瘤的發(fā)生和發(fā)展中的作用,減少腫瘤治療的并發(fā)癥。該研究旨在探討OSAS與喉部及下咽部惡性腫瘤的相關(guān)關(guān)系,為臨床的診療工作提供一定的指導(dǎo)意義。方法對2016年2月至9月間至鄭州大學(xué)第一附屬醫(yī)院耳鼻咽喉頭頸外科就診的50例術(shù)后病理最終確診為喉部或下咽部惡性腫瘤的患者,使用便攜式睡眠監(jiān)測儀進(jìn)行夜間睡眠監(jiān)測,監(jiān)測患者的睡眠呼吸暫停低通氣指數(shù)(Apnea Hypopnea Index,AHI)、平均血氧飽和度(Mean Oxygen Saturation)以及最低血氧飽和度(the Lowest Oxygen Saturation)等數(shù)據(jù)。AHI≥5次/h即可診斷為OSAS。根據(jù)AHI的大小將患者分為非OSAS組與OSAS組,比較兩組患者在年齡、性別、身高體重指數(shù)(Body Mass Index,BMI)、腫瘤部位及腫瘤分期等方面是否存在差異。以有無OSAS為因變量,以年齡、性別、BMI、腫瘤部位及腫瘤分期為自變量建立Logistic回歸方程,分析喉部及下咽部惡性腫瘤相關(guān)性O(shè)SAS的危險因素。結(jié)果按照OSAS的診斷標(biāo)準(zhǔn),本研究中的50例喉部及下咽部惡性腫瘤患者中有43例患者可診斷為OSAS,即患病率約為86%。其平均AHI為(15.81±11.87)次/h,平均平均血氧飽和度為(92.52±5.10)%,平均最低血氧飽和度為(72.80±10.78)%。OSAS組與非OSAS組患者在性別、BMI、腫瘤部位、腫瘤分期等方面均無統(tǒng)計學(xué)差異(P0.05),Logistic回歸分析顯示年齡是喉部及下咽部惡性腫瘤相關(guān)OSAS的危險因素。結(jié)論喉部及下咽部惡性腫瘤患者中OSAS的患病率較高,年齡是其相關(guān)危險因素,而該類患者中OSAS的患病率與患者的BMI、腫瘤部位及其分期無明顯關(guān)系。
[Abstract]:Background & objective obstructive Sleep Apnea syndromes (OSAs) is a common clinical disease. Genetic factors, anatomical factors, neurohumoral factors, obesity and many other factors are the common causes of the disease. OSAS may cause cardiovascular and cerebrovascular diseases. The serious complications of many systems, such as endocrine, have reduced the quality of life of patients, and even life-threatening. OSAS has been considered to be an independent risk factor for many systemic diseases. Studies have proved that OSAS can promote the occurrence and development of tumors. Laryngeal carcinoma and hypopharyngeal carcinoma are common malignant tumors of head and neck, and they are also the most common malignant tumors in the department of otorhinolaryngology. Most patients with malignant tumors of larynx and hypopharynx also have nocturnal sleep disorders. Symptoms such as daytime somnolence. Head and neck tumor patients with OSAS have higher postoperative complications. After treatment, the expression of various tumor-related genes in patients has decreased. It can be seen that the effective treatment of OSAS for tumor. Prevention and treatment are of certain significance. Therefore, the diagnosis and treatment of OSAS should be obtained as soon as possible. The purpose of this study was to investigate the relationship between OSAS and laryngeal and hypopharyngeal malignancies. Methods from February 2016 to September, 50 patients with malignant tumor of larynx or hypopharynx were treated in Department of Otorhinolaryngology head and neck surgery, the first affiliated Hospital of Zhengzhou University, from February 2016 to September. Use portable sleep monitor to monitor sleep at night, The data of apnea Hypopnea index, mean Oxygen saturation and Lowest Oxygen saturation. AHI 鈮，

本文編號：1635655