CAJ | 학술논문

目的研究对伴有鼻堵的阻塞性睡眠呼吸暂停低通气综合征(OSAHS)患者实施鼻腔扩容术后的治疗效果以及对鼾声声学特征的影响.方法 2011年4月-2012年10月卫生部北京医院耳鼻咽喉科22例行鼻腔扩容术的伴鼻阻塞的OSAHS患者的病历资料.患者手术前后分别进行整夜睡眠的鼾声、多导睡眠监测及鼻阻力检测.记录患者体质指数(BMI)、Epworth嗜睡量表(ESS)评分、呼吸暂停低通气指数(AHI)、最低动脉血氧饱和度(SaO2)、总鼻阻力以及鼾声声音信号的最大频率(fmax)、中心频率(fc)、平均频率(fmean)、峰值频率(fpeak)、800 Hz功率比(PR800)等各项声学参数.应用配对t检验比较手术前后BMI、ESS、AHI、最低SaO2、总鼻阻力的变化,Wilcoxon非参数检验比较各项声学参数的变化.结果 OSAHS患者手术后最低SaO2较术前升高,差异有统计学意义(P＜0.05).手术前后总鼻阻力分别为(0.39±0.15)和(0.29 ±0.11)Pa·cm-3·s-1,差异有统计学意义(P＜0.01).鼻腔扩容术前后OSAHS暂停后鼾声时域图、能量谱图均有明显变化.手术后,fpeak较术前降低,PR800较术前升高,差异均有统计学意义(均P＜0.01).结论鼻腔扩容手术降低了OSAHS患者的鼻阻力,改变了OSAHS患者的鼾声声学特征,鼾声有可能成为OSAHS手术疗效的评价指标之一.
목적 연구대반유비도적조새성수면호흡잠정저통기종합정(OSAHS)환자실시비강확용술후적치료효과이급대한성성학특정적영향.방법 2011년4월-2012년10월위생부북경의원이비인후과22례행비강확용술적반비조새적OSAHS환자적병력자료.환자수술전후분별진행정야수면적한성、다도수면감측급비조력검측.기록환자체질지수(BMI)、Epworth기수량표(ESS)평분、호흡잠정저통기지수(AHI)、최저동맥혈양포화도(SaO2)、총비조력이급한성성음신호적최대빈솔(fmax)、중심빈솔(fc)、평균빈솔(fmean)、봉치빈솔(fpeak)、800 Hz공솔비(PR800)등각항성학삼수.응용배대t검험비교수술전후BMI、ESS、AHI、최저SaO2、총비조력적변화,Wilcoxon비삼수검험비교각항성학삼수적변화.결과 OSAHS환자수술후최저SaO2교술전승고,차이유통계학의의(P＜0.05).수술전후총비조력분별위(0.39±0.15)화(0.29 ±0.11)Pa·cm-3·s-1,차이유통계학의의(P＜0.01).비강확용술전후OSAHS잠정후한성시역도、능량보도균유명현변화.수술후,fpeak교술전강저,PR800교술전승고,차이균유통계학의의(균P＜0.01).결론 비강확용수술강저료OSAHS환자적비조력,개변료OSAHS환자적한성성학특정,한성유가능성위OSAHS수술료효적평개지표지일.
Objective To explore the efficacies of nasal cavity enlarging surgery in obstructive sleep apnea hypopnea syndrome (OSAHS) patients with nasal obstruction.Methods From April 2011 to October 2012,a total of 22 OSAHS patient with nasal obstruction underwent nasal cavity enlargement.Natural overnight snoring was digitally recorded,polysomnography (PSG) performed simultaneously and nasal resistance measured at pre-and post-operation.Body mass index (BMI),Epworth sleepiness scale (ESS),apnea-hypopnea index (AHI),minimum oxygen saturation SaO2,total nasal resistance,peak frequency,maximal frequency,mean frequency,central frequency and power ratio 800 Hz of snores were recorded and compared.Results BMI and SaO2 rose while AHI and ESS declined post-operatively.No statistical difference existed between pre-operation and post-operation.The total nasal resistance was (0.39 ± 0.15)and (0.29 ± 0.11) Pa · cm-3 · s-1 at pre-and post-operation.And there was significant statistical difference(P ＜0.01).The snores at pre-and post-operation exhibited different patterns in time and power spectrum distribution domains.And fmax,fpeak and fmean declined while fe and PR800 rose at post-operation.Significant statistical differences existed in the change of fpeak and PR800 at pre-and post-operation(P ＜ 0.01).Conclusion Nasal cavity enlargement can lessen nasal resistance and change the acoustic characteristics of snoring in OSAHS patients.The postoperative snoring focus of lower frequency suggests that acoustic parameters of snores may be used to evaluate the efficacy of OSAHS surgery.