CAJ | 학술논문

目的应用鼻阻塞评分(nasal obstruction symptom evaluation,NOSE)及Mallampati评分(MS)评估阻塞性睡眠呼吸暂停综合征(obstructive sleep apnea syndrome,OSAS)患者鼻阻塞及口咽部情况,及相关影响因素,探讨NOSE评分及MS评分能否作为OSAS简单初筛诊断方法及危险度评估的方法.方法应用NOSE评分量表及MS评分对74例OSAS患者进行问卷调查,常规鼻腔检查,多导睡眠仪监测(PSG),记录体质量指数(BMI),所得结果进行统计分析.结果 ①NOSE评分与夜间睡眠呼吸紊乱指数(AHI)呈正相关(P＜0.01),与夜间平均血氧和最低血氧呈负相关(P＜0.01)；MS评分与BMI、夜间AHI呈正相关(P＜0.01),与夜间平均血氧和最低血氧呈负相关(P＜0.01).②NOSE评分与MS评分均高者夜间AHI更高.③NOSE评分与鼻中隔偏曲、下鼻甲肥大、过敏性鼻炎有相关性；AHI与鼻中隔偏曲、下鼻甲肥大有相关性,与过敏性鼻炎无相关性.结论在OSAS患者的评估中,既往靠PSG、ESS评分等了解患者的气道阻塞程度,但对具体阻塞部位不能由此做出判断.本文采用NOSE、MS评分,可以弥补相关不足,更好了解其主要阻塞部位,有较重要的临床意义,值得进一步探讨及研究.NOSE评分可作为OSAS患者鼻部情况的初筛方法,MS评分可评估其口咽部情况,NOSE评分与MS评分越高,OSAS患者相对危险率越高；OSAS患者增加了鼻腔结构(鼻中隔偏曲、下鼻甲肥大)改变的比例.临床上应重视评估OSAS患者鼻阻塞症状及口咽部情况,对其进行相关的健康教育及外科手术或呼吸机等治疗,提高患者的生活质量.
목적 응용비조새평분(nasal obstruction symptom evaluation,NOSE)급Mallampati평분(MS)평고조새성수면호흡잠정종합정(obstructive sleep apnea syndrome,OSAS)환자비조새급구인부정황,급상관영향인소,탐토NOSE평분급MS평분능부작위OSAS간단초사진단방법급위험도평고적방법.방법 응용NOSE평분량표급MS평분대74례OSAS환자진행문권조사,상규비강검사,다도수면의감측(PSG),기록체질량지수(BMI),소득결과진행통계분석.결과 ①NOSE평분여야간수면호흡문란지수(AHI)정정상관(P＜0.01),여야간평균혈양화최저혈양정부상관(P＜0.01)；MS평분여BMI、야간AHI정정상관(P＜0.01),여야간평균혈양화최저혈양정부상관(P＜0.01).②NOSE평분여MS평분균고자야간AHI경고.③NOSE평분여비중격편곡、하비갑비대、과민성비염유상관성；AHI여비중격편곡、하비갑비대유상관성,여과민성비염무상관성.결론 재OSAS환자적평고중,기왕고PSG、ESS평분등료해환자적기도조새정도,단대구체조새부위불능유차주출판단.본문채용NOSE、MS평분,가이미보상관불족,경호료해기주요조새부위,유교중요적림상의의,치득진일보탐토급연구.NOSE평분가작위OSAS환자비부정황적초사방법,MS평분가평고기구인부정황,NOSE평분여MS평분월고,OSAS환자상대위험솔월고；OSAS환자증가료비강결구(비중격편곡、하비갑비대)개변적비례.림상상응중시평고OSAS환자비조새증상급구인부정황,대기진행상관적건강교육급외과수술혹호흡궤등치료,제고환자적생활질량.
Objective To evaluate the impact of nasal obstruction and orpharynx on quality of life in patients with obstructive sleep apnea syndrome (OSAS) using Nasal Obstruction Symptom Evaluation (NOSE) scores and Mallampati scores(MS).To determine if NOSE scores and MS can be used to identify patients at risk for OSAS.Methods Seventy-four patients with OSAS were analyzed using NOSE scores and MS,and make routine examination of the nose.Record body mass index.All patients were evaluated with Polysomnography (PSG).The results were analyzed by statistics.Results The positive correlation between NOSE scores and sleep apnea hypopnea index (AHI) was significant.NOSE scores were negative correlated with night average blood oxygen and lowest blood oxygen.The positive correlation between MS and sleep AHI was significant.MS were negative correlated with night average blood oxygen and lowest blood oxygen.NOSE scores were related with deviation of nasal septum,inferior turbinate hypertrophy and allergic rhinitis.AHI were related with deviation of nasal septum and inferior turbinate hypertrophy,but no related with allergic rhinitis.Conclusions In the evaluation of patients with OSAS in the past,by PSG,ESS score of patients with airway obstruction,but not specific obstruction which judge.This paper adopts NOSE,MS score,can make up for lack of a better understanding of related,the main obstruction,has important clinical significance,is worthy of further discussion and research.NOSE score can be used as OSAS patients of nasal early screening method.The oropharyngeal situation can be evaluated by MS score.Patients with high NOSE scores and MS increased the risk of having OSAS.Patients with OSAS increased the proportion the change of the nasal cavity structure.We should pay more attention to evaluate the impact of nasal obstruction and orpharynx.The health education,related surgery or CPAP treatment.And try our best to improve the quality of life of the patients.