论文部分内容阅读
目的:研究鼻腔扩容术对多平面阻塞OSAHS患者主观与客观鼻腔通气状况及AHI、LSaO_2的改善情况。方法:对PSG监测确诊为OSAHS且经多种临床检查方式判断同时存在鼻咽平面及口咽平面阻塞而无喉咽平面阻塞的41例患者行鼻腔扩容手术治疗,所有多平面阻塞OSAHS患者术前行鼻声反射、鼻阻力检查评估患者客观鼻腔通气状况,并结合鼻阻塞症状评估(NOSE)量表评估其鼻塞严重程度。术后3个月再次行鼻声反射、鼻阻力检查及NOSE量表评估其鼻腔通气功能的改善情况,并行PSG监测评估OSAHS患者AHI、LSaO_2的术前及术后变化情况。结果:①鼻声反射、鼻阻力检查显示0~5cm的鼻腔容积(UV5)较术前变化明显(P<0.05),鼻阻力(NR)与NOSE评分较术前明显下降(P<0.05);②多平面阻塞OSAHS患者术后AHI较术前明显降低(P<0.05),LSaO_2较术前明显升高(P<0.05)。结论:①鼻腔扩容术能够有效改善多平面阻塞OSAHS患者的主观及客观鼻腔通气状况,且二者变化具有一致性;②鼻腔扩容术后多平面阻塞OSAHS患者的AHI明显降低,且能够从源头性因素逐步改善其低氧血症的程度,有助于后续治疗的安全、有效进行。
Objective: To study the subjective and objective nasal ventilation and the improvement of AHI and LSaO_2 in patients with OSAHS undergoing multiple nasal cavity expansion. Methods: Forty-one patients diagnosed as OSAHS by PSG and judged by multiple clinical examinations under nasal pharyngeal and oropharyngeal plaque obstruction without laryngopharyngeal obstruction were treated with nasal cavity expansion. All patients with multi-plane obstruction before OSAHS Nasal acoustic reflex and nasal resistance were used to evaluate objective nasal ventilation. The severity of nasal congestion was evaluated with nasal obstruction symptom assessment (NOSE) scale. Three months after operation, nasal reflex, nasal resistance test and NOSE scale were used to evaluate the improvement of nasal ventilation function. PSG monitoring was performed to evaluate the changes of AHI and LSaO_2 in OSAHS patients before and after operation. Results: (1) Nasal reflex and nasal resistance test showed that the volume of nasal cavity (UV5) at 0 ~ 5cm was significantly higher than that before operation (P <0.05), while NR and NOSE were significantly decreased (P <0.05); The AHI in patients with multiplanar OSAHS was significantly lower than that before operation (P <0.05), and LSaO_2 was significantly higher than that before operation (P <0.05). Conclusions: nasal cavity expansion can effectively improve subjective and objective nasal ventilation in patients with OSAHS with multiple planar obstruction, and the changes are consistent. The AHI of multi-plane obstruction OSAHS patients after nasal cavity expansion is obviously decreased, Factors gradually improve the degree of hypoxemia, contribute to the safe and effective follow-up treatment.