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目的通过回顾药物诱导睡眠内镜检查结果,寻找阻塞性睡眠呼吸暂停低通气综合征(OSAHS)患者上气道塌陷形态与多导睡眠监测结果的关联。方法经多导睡眠监测(PSG)诊断为OSAHS的患者51例,右美托咪定诱导睡眠后内镜观察仰卧位患者睡眠期腭咽、口咽侧壁、舌根、会厌和喉部5个部位的塌陷情况,并分析与多导睡眠监测仪(PSG)监测参数的相关性。结果腭咽部完全阻塞患者的呼吸暂停指数(AHI)、氧降指数(ODI)、血氧饱和度低于90%时间比(T<90%)明显高于不完全阻塞患者,最低血氧饱和度(LSaO_2)明显低于不完全阻塞患者。口咽部塌陷方向均为X轴方向,即表现为侧壁塌陷,完全阻塞或不完全阻塞患者相较无阻塞患者,有着明显增高的AHI、ODI和T<90%,明显降低的LSaO_2。结论口咽侧壁及腭咽部的阻塞表现出更明显的低氧血症,需要重视并予以积极治疗。
Objective To investigate the relationship between upper airway collapse morphology and polysomnography in patients with obstructive sleep apnea-hypopnea syndrome (OSAHS) by reviewing the results of drug-induced sleep endoscopy. Methods Fifty-one patients diagnosed as OSAHS by polysomnography (PSG) were enrolled in this study. Dexmedetomidine was used to induce end-stage sleep in 5 patients, including palatopharyngeal pharynx, oropharyngeal wall, tongue base, epiglottis and larynx Of the collapse, and analysis and polysomnography (PSG) monitoring parameters correlation. Results The AHI, ODI, and oxygen saturation below 90% of patients with complete velopharyngeal obstruction were significantly higher than those with incomplete obstruction (T <90%), and the lowest oxygen saturation Degree (LSaO_2) was significantly lower than patients with incomplete obstruction. The oropharyngeal collapse direction is in the direction of X-axis, which is manifested as side wall collapse, complete obstruction or incomplete obstruction in patients with non-blocking patients, with significantly higher AHI, ODI and T <90%, significantly lower LSaO_2. Conclusion Obstruction of oropharyngeal wall and velopharyngeal showed more obvious hypoxemia, which needs attention and be actively treated.