中国医师杂志
中國醫師雜誌
중국의사잡지
JOURNAL OF CHINESE PHYSICIAN
2014年
9期
1216-1220
,共5页
睡眠呼吸暂停,阻塞性/外科学%悬雍垂/外科学%咽/外科学%腭/外科学%听力检查%测听法,纯音%耳声发射,自发性%诱发电位,听觉,脑干
睡眠呼吸暫停,阻塞性/外科學%懸雍垂/外科學%嚥/外科學%腭/外科學%聽力檢查%測聽法,純音%耳聲髮射,自髮性%誘髮電位,聽覺,腦榦
수면호흡잠정,조새성/외과학%현옹수/외과학%인/외과학%악/외과학%은력검사%측은법,순음%이성발사,자발성%유발전위,은각,뇌간
Sleep apnea,obstructive/surgery%Uvula/surgery%Pharynx/surgery%Palate/surgery%Hearing tests%Audiometry,pure-tone%Otoacoustic emissions,spontaneous%Evoked potentials,auditory,brain stem
目的 探讨成年重度阻塞性睡眠呼吸暂停低通气综合征(0SAHS)患者悬雍垂腭咽成形术(UPPP)前后听觉功能检查的变化.分析低氧血症、高碳酸血症影响听觉功能及手术对听觉改善的可能机制.方法 对82例经多导睡眠监测确诊为重度OSAHS成年患者,分别于术前和术后6个月各行至少一次纯音测听、听性脑干反应(ABR)及畸变产物耳声发射(DPOAE)检测.另选43例无打鼾的健康志愿者作为对照组同样行上述各项检测.结果 (1)82例OSAHS患者术后随访至少6个月,其中治愈51例,显效24例,有效7例,总有效率为100％.(2)常频纯音测听两组频率在250～4 000 Hz差异无统计学意义(P＞0.05),而＞4000 Hz扩展高频听阈OSAHS组明显高于对照组(P＜0.05);术后患者主观听觉明显改善,扩展高频区听域提高＞30 dB(P＜0.05).(3)OSAHS组ABR波Ⅰ、Ⅴ潜伏期及Ⅲ～Ⅴ间期较对照组显著延长(P＜0.05),术前术后差异无统计学意义(P＞0.05).(4)OSAHS术前组DPOAE检出率及幅值在各个频率点较对照组均显著下降(P＜0.05),且术前和术后检出结果差异有统计学意义(P＜0.05).结论 重度OSAHS引起的慢性缺氧可以导致听觉功能受损,手术治疗有助于听觉功能的康复.
目的 探討成年重度阻塞性睡眠呼吸暫停低通氣綜閤徵(0SAHS)患者懸雍垂腭嚥成形術(UPPP)前後聽覺功能檢查的變化.分析低氧血癥、高碳痠血癥影響聽覺功能及手術對聽覺改善的可能機製.方法 對82例經多導睡眠鑑測確診為重度OSAHS成年患者,分彆于術前和術後6箇月各行至少一次純音測聽、聽性腦榦反應(ABR)及畸變產物耳聲髮射(DPOAE)檢測.另選43例無打鼾的健康誌願者作為對照組同樣行上述各項檢測.結果 (1)82例OSAHS患者術後隨訪至少6箇月,其中治愈51例,顯效24例,有效7例,總有效率為100％.(2)常頻純音測聽兩組頻率在250～4 000 Hz差異無統計學意義(P＞0.05),而＞4000 Hz擴展高頻聽閾OSAHS組明顯高于對照組(P＜0.05);術後患者主觀聽覺明顯改善,擴展高頻區聽域提高＞30 dB(P＜0.05).(3)OSAHS組ABR波Ⅰ、Ⅴ潛伏期及Ⅲ～Ⅴ間期較對照組顯著延長(P＜0.05),術前術後差異無統計學意義(P＞0.05).(4)OSAHS術前組DPOAE檢齣率及幅值在各箇頻率點較對照組均顯著下降(P＜0.05),且術前和術後檢齣結果差異有統計學意義(P＜0.05).結論 重度OSAHS引起的慢性缺氧可以導緻聽覺功能受損,手術治療有助于聽覺功能的康複.
목적 탐토성년중도조새성수면호흡잠정저통기종합정(0SAHS)환자현옹수악인성형술(UPPP)전후은각공능검사적변화.분석저양혈증、고탄산혈증영향은각공능급수술대은각개선적가능궤제.방법 대82례경다도수면감측학진위중도OSAHS성년환자,분별우술전화술후6개월각행지소일차순음측은、은성뇌간반응(ABR)급기변산물이성발사(DPOAE)검측.령선43례무타한적건강지원자작위대조조동양행상술각항검측.결과 (1)82례OSAHS환자술후수방지소6개월,기중치유51례,현효24례,유효7례,총유효솔위100％.(2)상빈순음측은량조빈솔재250～4 000 Hz차이무통계학의의(P＞0.05),이＞4000 Hz확전고빈은역OSAHS조명현고우대조조(P＜0.05);술후환자주관은각명현개선,확전고빈구은역제고＞30 dB(P＜0.05).(3)OSAHS조ABR파Ⅰ、Ⅴ잠복기급Ⅲ～Ⅴ간기교대조조현저연장(P＜0.05),술전술후차이무통계학의의(P＞0.05).(4)OSAHS술전조DPOAE검출솔급폭치재각개빈솔점교대조조균현저하강(P＜0.05),차술전화술후검출결과차이유통계학의의(P＜0.05).결론 중도OSAHS인기적만성결양가이도치은각공능수손,수술치료유조우은각공능적강복.
Objective To investigate the changes of uvulopalatopharyngoplasty on the auditory function in adult patients with severe obstructive sleep apnea-hypopnea syndrome (OSAHS).The possible mechanism of hypoxemia was analyzed,and hypercapnia might affect auditory function and the effect of operation to hearing was improved.Methods A total of 82 adult patients who were made a diagnosis by polysomnography (PSG) with severe OSAHS had been diagnosed by pure tone audiometry,tympa-nometry,auditory brainstem responses (ABR),and otoacoustic emissions (OAE) before and 6 months after surgical treatments.The control group included 43 non-snoring healthy people through the same line of the above test.Results (1)Among 82 patients who underwent uvulopalatopharyngoplasty,symptoms were resolved in 51 patients,significantly improved in 24 patients,and somewhat improved in7 patients at 6 months followed-up,yielding a total effective rate of 100％.(2)There were no significant differences in hearing threshold across 250 to 4 000 Hz on pure tone audiometry between OSAHS and control groups (P ＞ 0.05),although hearing thresholds at high frequencies showed significant differences (P ＜ 0.05).(3)The latencies of ABR waves Ⅰ and Ⅴ in the OSAHS group were significantly longer than control group (P ＜ 0.05).The interpeak lantency intervals of wave Ⅲ ～ Ⅴ in patients with OSAHS were longer than that in the control group (P ＜ 0.05).No significant difference was showed before and after surgery (P ＞ 0.05).(4)Distortion product otoacoustic emission (DPOAE) detection rate and amplitudes at all frequencies were poorer in OSAHS group before surgery compared with the control group (P ＜ 0.05),and significant changes were found after surgical treatments (P ＜ 0.05).Conclusions OSAHS can impair auditory function,probably from chronic hypoxia,which can be improved by surgical treatment in adult patients with severe OSAHS.
