CAJ | 학술논문

目的通过成年人重度阻塞性睡眠呼吸暂停低通气综合征(obstructive sleep apnea-hypopnea syndrome, OSAHS)患者手术前后听觉功能检查的对照研究,了解OSAHS患者术后听力康复的情况.方法对73例手术治疗的成年人重度OSAHS患者在术前和术后6个月分别行多导睡眠监测(PSG)、纯音测听及声导抗、听性脑干电位(ABR)及耳声发射(OAE)检测.另对20例无打鼾的健康志愿者同样行上述各项检测.结果①73例OSAHS患者术后随访治疗6月,其中治愈48例,显效22例,有效3例,总有效率为100%.②两组250~4000 Hz气导纯音测听结果无显著差异(P>0.05),>4000 Hz高频听阈有显著差异(P<0.05);术后患者主观听觉明显改善,高频区听域提高>30dB(P<0.05).③OSAHS组听性脑干反应波l、V潜伏期较对照组显著延长(P<O.05),术前术后无显著差异.④OSAHS术前组畸变产物耳声发射(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显著(P<0.05).结论成年人重度OSAHS患者由于长期缺氧可以导致听觉功能受损,行上呼吸道多平面分期手术治疗有利于重度OSAHS患者听觉功能的康复.
목적통과성년인중도조새성수면호흡잠정저통기종합정(obstructive sleep apnea-hypopnea syndrome, OSAHS)환자수술전후은각공능검사적대조연구,료해OSAHS환자술후은력강복적정황.방법대73례수술치료적성년인중도OSAHS환자재술전화술후6개월분별행다도수면감측(PSG)、순음측은급성도항、은성뇌간전위(ABR)급이성발사(OAE)검측.령대20례무타한적건강지원자동양행상술각항검측.결과①73례OSAHS환자술후수방치료6월,기중치유48례,현효22례,유효3례,총유효솔위100%.②량조250~4000 Hz기도순음측은결과무현저차이(P>0.05),>4000 Hz고빈은역유현저차이(P<0.05);술후환자주관은각명현개선,고빈구은역제고>30dB(P<0.05).③OSAHS조은성뇌간반응파l、V잠복기교대조조현저연장(P<O.05),술전술후무현저차이.④OSAHS술전조기변산물이성발사(DPOAE)검출솔급폭치재각개빈솔점교대조조균현저하강(P<0.05),차술전화술후검출결과차이현저(P<0.05).결론성년인중도OSAHS환자유우장기결양가이도치은각공능수손,행상호흡도다평면분기수술치료유리우중도OSAHS환자은각공능적강복.
@@@@Objective To investigate the effect of upper respiratory tract surgical treatments on the auditory function in adult patients with severe OSAHS. Methods The OSAHS group included 73 adult patients with severe OSAHS, and the control group included 20 non-snoring healthy people, Polysomnography monitoring (PSG), pure tone audiometry, tympa?nometry, auditory brainstem responses (ABR) and otoacoustic emissions (OAE) were performed in control group subjects and in patients in the OSAHS group before and 6 months after surgical treatments. Results 1) Of the 73 patients who under?went surgical treatments, symptoms resolved in 48 patients, significantly improved in 22 patients and somewhat improved in 3 patients at 6 months followed-up, yielding a total effective rate of 100%. 2) There were no significant differences in hear?ing thresholds across 250 to 4000 Hz on pure tone audiometry between the OSAHS and the control group (P > 0.05), al?though 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 in the control group (P<0.05), and showed no significant differ?ence before and after surgery (P>0.05) . 4) DPOAE detection rate and amplitudes at all frequencies were poorer in the OSAHS group before surgery compared with the control group (P<0.05) and showed significant changes after surgical treat? ments (P < 0.05). Conclusion OSAHS can impair auditory function, probably from chronic hypoxia, which can be im?proved by surgical treatments in adult patients with severe OSAHS.