中华结核和呼吸杂志
中華結覈和呼吸雜誌
중화결핵화호흡잡지
Chinese Journal of Tuberculosis and Respiratory Diseases
2012年
3期
180-183
,共4页
张向峰%高元明%朱光发%杨京华%丁少芳%刘双
張嚮峰%高元明%硃光髮%楊京華%丁少芳%劉雙
장향봉%고원명%주광발%양경화%정소방%류쌍
肺血栓栓塞症%睡眠呼吸暂停低通气综合征%临床特点%治疗
肺血栓栓塞癥%睡眠呼吸暫停低通氣綜閤徵%臨床特點%治療
폐혈전전새증%수면호흡잠정저통기종합정%림상특점%치료
Pulmonary thromboembolism%Sleep apnea syndrome%Clinical features%Treatment
目的 调查肺血栓栓塞症(PTE)患者合并OSAHS患者的临床特点,研究合并OSAHS对于PTE患者起病及病情严重程度的影响并比较临床干预的差异.方法 分析2002年1月至2010年12月期间北京安贞医院呼吸科收治的28例合并OSAHS的住院PTE患者的一般情况、吸烟指数、栓塞面积、是否合并高血压、肺动脉高压和下肢深静脉血栓(DVT)等,观察动脉血气分析结果、呼吸暂停低通气指数( AHI)、夜间最低脉搏氧饱和度(SpO2)和所接受的临床干预措施,并与30例不合并OSAHS的PTE患者进行比较.结果 合并OSAHA的住院FT'E患者年龄[(55±11)岁]较不合并OSAHS的PTE患者年轻[(66±11)岁,t=3.230,P＜0.01],体重指数[(30.1±2.8)kg/m2 vs (26.1±3.1) kg/m2,t=-4.161,P＜0.001]和吸烟指数[(19±6)包年vs(8±4)包年,t=- 1.713,P＜0.05]均大于后者；Pa02明显低于未合并OSAHS的PTE患者[(70±8) mm Hg vs (79±6) mm Hg,1 mm Hg=0.133 kPa,t =4.233,P＜0.05]；栓塞累及的肺段数量多于不合并OSAHS组[(8±4)个vs(5±3)个,t=-2.496,P＜0.05].2组均采用抗凝和(或)溶栓治疗,部分合并OSAHS的PTE患者在此基础上应用无创正压通气(CPAP)治疗.结论 合并PTE的住院OSAHS患者一般发病年龄较轻,肺栓塞病情较重,临床上需要采取以抗凝和CPAP为主的综合治疗.
目的 調查肺血栓栓塞癥(PTE)患者閤併OSAHS患者的臨床特點,研究閤併OSAHS對于PTE患者起病及病情嚴重程度的影響併比較臨床榦預的差異.方法 分析2002年1月至2010年12月期間北京安貞醫院呼吸科收治的28例閤併OSAHS的住院PTE患者的一般情況、吸煙指數、栓塞麵積、是否閤併高血壓、肺動脈高壓和下肢深靜脈血栓(DVT)等,觀察動脈血氣分析結果、呼吸暫停低通氣指數( AHI)、夜間最低脈搏氧飽和度(SpO2)和所接受的臨床榦預措施,併與30例不閤併OSAHS的PTE患者進行比較.結果 閤併OSAHA的住院FT'E患者年齡[(55±11)歲]較不閤併OSAHS的PTE患者年輕[(66±11)歲,t=3.230,P＜0.01],體重指數[(30.1±2.8)kg/m2 vs (26.1±3.1) kg/m2,t=-4.161,P＜0.001]和吸煙指數[(19±6)包年vs(8±4)包年,t=- 1.713,P＜0.05]均大于後者；Pa02明顯低于未閤併OSAHS的PTE患者[(70±8) mm Hg vs (79±6) mm Hg,1 mm Hg=0.133 kPa,t =4.233,P＜0.05]；栓塞纍及的肺段數量多于不閤併OSAHS組[(8±4)箇vs(5±3)箇,t=-2.496,P＜0.05].2組均採用抗凝和(或)溶栓治療,部分閤併OSAHS的PTE患者在此基礎上應用無創正壓通氣(CPAP)治療.結論 閤併PTE的住院OSAHS患者一般髮病年齡較輕,肺栓塞病情較重,臨床上需要採取以抗凝和CPAP為主的綜閤治療.
목적 조사폐혈전전새증(PTE)환자합병OSAHS환자적림상특점,연구합병OSAHS대우PTE환자기병급병정엄중정도적영향병비교림상간예적차이.방법 분석2002년1월지2010년12월기간북경안정의원호흡과수치적28례합병OSAHS적주원PTE환자적일반정황、흡연지수、전새면적、시부합병고혈압、폐동맥고압화하지심정맥혈전(DVT)등,관찰동맥혈기분석결과、호흡잠정저통기지수( AHI)、야간최저맥박양포화도(SpO2)화소접수적림상간예조시,병여30례불합병OSAHS적PTE환자진행비교.결과 합병OSAHA적주원FT'E환자년령[(55±11)세]교불합병OSAHS적PTE환자년경[(66±11)세,t=3.230,P＜0.01],체중지수[(30.1±2.8)kg/m2 vs (26.1±3.1) kg/m2,t=-4.161,P＜0.001]화흡연지수[(19±6)포년vs(8±4)포년,t=- 1.713,P＜0.05]균대우후자；Pa02명현저우미합병OSAHS적PTE환자[(70±8) mm Hg vs (79±6) mm Hg,1 mm Hg=0.133 kPa,t =4.233,P＜0.05]；전새루급적폐단수량다우불합병OSAHS조[(8±4)개vs(5±3)개,t=-2.496,P＜0.05].2조균채용항응화(혹)용전치료,부분합병OSAHS적PTE환자재차기출상응용무창정압통기(CPAP)치료.결론 합병PTE적주원OSAHS환자일반발병년령교경,폐전새병정교중,림상상수요채취이항응화CPAP위주적종합치료.
Objective To describe the clinical features of obstructive sleep apnea-hyponea syndrome (OSAHS) in hospitalized pulmonary thromboembolism (PTE) patients,and to explore its impact on the severity of disease and management among patients with PTE.Methods Demographic and clinical characteristics of 28 PTE patients complicated with OSAHS admitted to this hospital from January 2002 to December 2010 were analyzed.A total of 30 PTE patients without OSAHS served as a control group.Results PTE patients with OSAHS had a significantly lower age of onset of disease [ (55 + 11 ) yr vs ( 66 + 11 ) yr,t =3.230,P ＜ 0.01 ],an increased body mass index ( BMI ) [ ( 30.1 ± 2.8 ) kg/m2 vs ( 26.1 ± 3.1 )kg/m2,t =-4.161,P ＜0.001 ] and a higher smoking index [ ( 19 ±6) packs/yr vs (8 ±4) packs/yr,t=-1.713,P＜0.05] when compared with PTE patients without OSAHS.PaO2 [(70 ±8) mm Hg vs (79±6) mm Hg,1 mm Hg=0.133 kPa,t =4.233,P＜O.05] and involved lung segments [(8 ±4) vs ( 5 + 3),t =- 2.496,P ＜ 0.05 ] in PTE patients with OSAHS were more severe than those in PTE patients without OSAHS.All patients received anticoagulation and/or thrombolysis treatment,and continuous positive airway pressure (CPAP) ventilation was used in some PTE patients with OSAHS. Conclusion PTE patients with OSAHS had a significantly earlier age of onset of disease and more severe conditions than PTE patients without OSAHS.Treatments including anticoagulation and CPAP should be used in these patients.
