功能保全性聲門癌手術(shù)患者睡眠呼吸狀況的觀察
發(fā)布時間：2018-08-21 07:39
【摘要】：目的:探討聲門癌患者手術(shù)前和功能保全性聲門癌手術(shù)后睡眠呼吸紊亂的狀況,以及功能保全性聲門癌手術(shù)的不同術(shù)式對患者睡眠呼吸紊亂的影響。方法:采用便攜式多導(dǎo)睡眠監(jiān)測儀對未經(jīng)任何治療的66例聲門癌患者和已行功能保全性聲門癌手術(shù)并拔除氣管套管6月以上的58例聲門癌患者進行阻塞性睡眠呼吸暫停低通氣綜合征(obstrucive sleep apnea hypopnea syndrome,OSAHS)篩查;參照標(biāo)準(zhǔn)為中華耳鼻咽喉頭頸外科雜志編委會和中華醫(yī)學(xué)會耳鼻咽喉頭頸外科分會咽喉學(xué)組(2009)制定的《阻塞性睡眠呼吸暫停低通氣綜合征診斷和外科治療指南》;對功能保全性聲門癌手術(shù)后患者按照手術(shù)切除喉部軟骨支架等重要結(jié)構(gòu)范圍的不同分為手術(shù)范圍較大組和手術(shù)范圍較小組兩組;按照上述指南以呼吸暫停低通氣指數(shù)(apnea-hypopnea index,AHI)為標(biāo)準(zhǔn)對OSAHS病情進行評判,以最低血氧飽和度(the lowest blood oxygen saturation,LSa O2)判斷低氧血癥程度;對所得結(jié)果進行統(tǒng)計分析。結(jié)果:(1)未經(jīng)治療的聲門癌患者66例中符合OSAHS診斷標(biāo)準(zhǔn)者38例(57.57%),58例功能保全性聲門癌手術(shù)后患者中符合OSAHS診斷標(biāo)準(zhǔn)者32例(55.17%),兩組比較差異無統(tǒng)計學(xué)意義(X2=0.073,P0.05);66例未經(jīng)治療的聲門癌患者中符合重度OSAHS者2例(3.03%),功能保全性聲門癌手術(shù)患者58例中符合重度OSAHS者8例(13.79%),兩組比較差異有統(tǒng)計學(xué)意義(X2=4.823,P0.05);(2)功能保全性聲門癌手術(shù)后患者中,手術(shù)范圍較大組18例中符合OSAHS診斷標(biāo)準(zhǔn)者14例(77.78%),手術(shù)范圍較小組患者40例中符合OSAHS診斷標(biāo)準(zhǔn)者18例(45.00%),兩組比較差異有統(tǒng)計學(xué)意義(X2=5.393,P0.05);手術(shù)范圍較大組18例中符合中、重度OSAHS診斷標(biāo)準(zhǔn)者10例(55.56%),手術(shù)范圍較小組40例中符合中、重度OSAHS診斷標(biāo)準(zhǔn)者10例(25.00%),兩組比較差異有統(tǒng)計學(xué)意義(X2=5.130,P0.05)。結(jié)論:(1)未經(jīng)治療的聲門癌患者OSAHS患病率較高;(2)功能保全性手術(shù)后的聲門癌患者具有較高的OSAHS患病率,術(shù)后OSAHS的嚴(yán)重程度較未手術(shù)者有所加重;對喉結(jié)構(gòu)破壞范圍較大的功能保全性手術(shù)后的聲門癌患者OSAHS的程度較重;未經(jīng)治療的和功能保全性手術(shù)后的聲門癌患者的睡眠呼吸障礙值得重視。
[Abstract]:Objective: to investigate the status of sleep apnea disorder in patients with glottic carcinoma before and after operation. Methods: 66 patients with glottic cancer without any treatment and 58 patients with glottic carcinoma who had been operated on and tracheal cannula removed for more than six months were treated with a portable polysomnography. (obstrucive sleep apnea hypopnea syndromesia OSAHS screening; The standard of reference was the "guidelines for the diagnosis and surgical treatment of obstructive sleep apnea hypopnea syndrome" developed by the editorial Committee of the Chinese Journal of Otolaryngology and head and neck surgery of Otolaryngology and the pharyngopharyngology Group of the Otolaryngology Branch of the Chinese Medical Association (2009). Patients with functionally safe glottic carcinoma were divided into two groups according to the different range of important structures such as resection of laryngochondral stents. According to the above guidelines, the apnea-hypopnea index of hypopnea (apnea-hypopnea index AHI) was used to judge the condition of OSAHS, and the lowest oxygen saturation (the lowest blood oxygen saturation) was used to judge the degree of hypoxemia, and the results were statistically analyzed. Results: (1) of 66 patients with untreated glottic carcinoma, 38 (57.57%) met the OSAHS diagnostic criteria. 32 (55.17%) of 58 patients with functionally safe glottic carcinoma met the diagnostic criteria of OSAHS (55.17%). There was no significant difference between the two groups (X2 / 0.073, P0.05) in 66 untreated patients. There were 2 cases (3.03%) with severe OSAHS in glottic carcinoma and 8 cases (13.79%) with severe OSAHS in 58 patients with functionally safe glottic carcinoma. The difference between the two groups was statistically significant (X24.823 p0.05); (2). In the larger group, 14 cases (77.78%) met the diagnostic criteria of OSAHS, and 18 cases (45.00%) met the diagnostic criteria of OSAHS in comparison with the group of 40 patients. The difference between the two groups was statistically significant (X25.393P 0.05), and in the larger group of 18 cases, the range of operation was in accordance with the standard of OSAHS (45.00%). There were 10 cases (55.56%) with severe OSAHS, 10 cases (25.00%) with severe OSAHS and 10 cases (25.00%) with moderate or severe OSAHS. The difference between the two groups was statistically significant (P 0.05). Conclusion: (1) the prevalence of OSAHS in patients with untreated glottic carcinoma is higher than that in patients with untreated glottic carcinoma. (2) the incidence of OSAHS in patients with glottic carcinoma after functional preservation surgery is higher than that in patients without operation, and the severity of OSAHS after operation is more serious than that in patients without operation. The degree of OSAHS in patients with glottic carcinoma after laryngeal structure preservation surgery is more serious, and sleep apnea disorder in patients with glottic carcinoma after untreated and functional preservation surgery is worthy of attention.
【學(xué)位授予單位】：青島大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2017
【分類號】：R739.6
本文編號：2195018
[Abstract]:Objective: to investigate the status of sleep apnea disorder in patients with glottic carcinoma before and after operation. Methods: 66 patients with glottic cancer without any treatment and 58 patients with glottic carcinoma who had been operated on and tracheal cannula removed for more than six months were treated with a portable polysomnography. (obstrucive sleep apnea hypopnea syndromesia OSAHS screening; The standard of reference was the "guidelines for the diagnosis and surgical treatment of obstructive sleep apnea hypopnea syndrome" developed by the editorial Committee of the Chinese Journal of Otolaryngology and head and neck surgery of Otolaryngology and the pharyngopharyngology Group of the Otolaryngology Branch of the Chinese Medical Association (2009). Patients with functionally safe glottic carcinoma were divided into two groups according to the different range of important structures such as resection of laryngochondral stents. According to the above guidelines, the apnea-hypopnea index of hypopnea (apnea-hypopnea index AHI) was used to judge the condition of OSAHS, and the lowest oxygen saturation (the lowest blood oxygen saturation) was used to judge the degree of hypoxemia, and the results were statistically analyzed. Results: (1) of 66 patients with untreated glottic carcinoma, 38 (57.57%) met the OSAHS diagnostic criteria. 32 (55.17%) of 58 patients with functionally safe glottic carcinoma met the diagnostic criteria of OSAHS (55.17%). There was no significant difference between the two groups (X2 / 0.073, P0.05) in 66 untreated patients. There were 2 cases (3.03%) with severe OSAHS in glottic carcinoma and 8 cases (13.79%) with severe OSAHS in 58 patients with functionally safe glottic carcinoma. The difference between the two groups was statistically significant (X24.823 p0.05); (2). In the larger group, 14 cases (77.78%) met the diagnostic criteria of OSAHS, and 18 cases (45.00%) met the diagnostic criteria of OSAHS in comparison with the group of 40 patients. The difference between the two groups was statistically significant (X25.393P 0.05), and in the larger group of 18 cases, the range of operation was in accordance with the standard of OSAHS (45.00%). There were 10 cases (55.56%) with severe OSAHS, 10 cases (25.00%) with severe OSAHS and 10 cases (25.00%) with moderate or severe OSAHS. The difference between the two groups was statistically significant (P 0.05). Conclusion: (1) the prevalence of OSAHS in patients with untreated glottic carcinoma is higher than that in patients with untreated glottic carcinoma. (2) the incidence of OSAHS in patients with glottic carcinoma after functional preservation surgery is higher than that in patients without operation, and the severity of OSAHS after operation is more serious than that in patients without operation. The degree of OSAHS in patients with glottic carcinoma after laryngeal structure preservation surgery is more serious, and sleep apnea disorder in patients with glottic carcinoma after untreated and functional preservation surgery is worthy of attention.
【學(xué)位授予單位】：青島大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2017
【分類號】：R739.6
【參考文獻】
相關(guān)期刊論文 前10條
1 蘇軼;徐偉偉;王向云;張志莉;曹迎春;于秋紅;李建東;;東營市東營區(qū)老年人阻塞性睡眠呼吸暫停低通氣綜合征流行病學(xué)調(diào)查[J];臨床耳鼻咽喉頭頸外科雜志;2016年04期
2 陳文杰;王斌全;高偉;劉瑛;張晨;任倩;;喉癌流行病學(xué)特征及影響因素分析[J];中國當(dāng)代醫(yī)藥;2015年12期
3 王輝;施戀;王玉梅;趙春輝;羅鵬;李森龍;肖建蘭;;51例睡眠打鼾患者應(yīng)用多導(dǎo)睡眠監(jiān)測系統(tǒng)監(jiān)測的臨床分析[J];中國醫(yī)學(xué)工程;2014年12期
4 晉發(fā);蔡偉;楊健;張秀偉;;便攜式睡眠檢測儀對OSAHS的診斷價值[J];世界睡眠醫(yī)學(xué)雜志;2014年05期
5 李曉明;;喉癌外科手術(shù)及綜合治療專家共識[J];中華耳鼻咽喉頭頸外科雜志;2014年08期
6 曾紅梅;陳萬青;;中國癌癥流行病學(xué)與防治研究現(xiàn)狀[J];化學(xué)進展;2013年09期
7 胡海琴;黃靜;;喉癌患者喉切除術(shù)后睡眠障礙影響因素的質(zhì)性研究[J];解放軍護理雜志;2013年18期
8 王德樂;韋一;陳學(xué)良;曾莉;王韶鑒;;便攜式多導(dǎo)睡眠監(jiān)測系統(tǒng)的臨床應(yīng)用[J];中國耳鼻咽喉顱底外科雜志;2013年04期
9 葉凡;陳建福;林刃輿;方瀟碧;嚴(yán)毛曉;;喉癌術(shù)后患者主觀睡眠質(zhì)量與抑郁狀況的調(diào)查研究[J];醫(yī)學(xué)研究雜志;2012年10期
10 王玲;孔慧;蘇英峰;;176例多導(dǎo)睡眠呼吸監(jiān)測結(jié)果及臨床分析[J];大連醫(yī)科大學(xué)學(xué)報;2012年02期
，本文編號：2195018
本文鏈接：http://sikaile.net/yixuelunwen/zlx/2195018.html
最近更新
教材專著
