吕苏明，张天友，丁 利，林月友

(浙江省人民医院， 浙江 杭州 310014)

·基础与临床研究·

高压氧治疗阻塞型睡眠呼吸暂停低通气综合征疗效分析

吕苏明，张天友，丁 利，林月友

(浙江省人民医院， 浙江 杭州 310014)

目的：通过分析高压氧治疗阻塞型睡眠呼吸暂停低通气综合征(OSAHS)前后多导呼吸睡眠监测(PSG)数据，探讨其治疗疗效。方法对2012年12月至2015年4月40例OSAHS患者治疗，对比观察治疗前后PSG数据，包括呼吸暂停低通气指数、最长呼吸暂停时间、睡眠期最低血氧饱和度、睡眠期平均血氧饱和度、睡眠结构等，并结合患者年龄，BMI等进行分析。结果治疗前患者年龄、BMI、REM睡眠与AHI值有极显著性差异(P<0.01)。高压氧治疗前后快速眼动期睡眠2组间差异有显著性改善(P<0.05)。治疗前后AHI指数，呼吸暂停指数，最长呼吸暂停时间，低通气指数，最低血氧饱和度，平均血氧饱和度等变化有改善(P<0.01)。结论高压氧治疗能改善阻塞型睡眠呼吸暂停综合征患者的呼吸调节功能和睡眠结构，减轻夜间缺氧程度和相应症状。

高压氧治疗；阻塞型睡眠呼吸暂停低通气综合征；多导睡眠监测

Abstract: [Objective] To explore the clinical features and diagnosis of the patients with obstructive sleep apnea hypopnea syndrome (OSAHS) treated by hyperbaric oxygen therapies. [Method] Forty patients with OSAHS were selected, every patient was monitored with polysomnography (PSG) at night, the data were analyzed including NREM, REM, AHI(First appear, No Abbreviations!!), the longest apnea time, SaO2, etc. Meanwhile, the parameters were compared before and after the hyperbaric oxygen treatment, also the relationships between groups in age, BMI, sleep architecture and AHI before treatment were analyzed. [Result] There was statistically significant differences between groups in AHI index and age, BMI, REM sleep (P<0.01).The difference in REMs before and after treatment was significant (P<0.05). Also, the difference in PSG index before and after the treatment was statistically significant (P<0.01). [Conclusion] Hyperbaric oxygen treatment can effectively improve respiratory regulatory function, sleep quality and a series of clinical symptoms in patients with OSAHS.

Keywords: hyperbaric oxygen therapies；Obstructive Sleep Apnea Hypopnea Syndrome (OSAHS)；polysomnography (PSG)

睡眠呼吸暂停综合征 (Sleep Apnea Syndrome，SAS)分为中枢型(Central Sleep Apnea Syndrome，CSAS) 、阻塞型(Obstructivesleep Apnea Syndrome，OSAS)、混合型(Mixed Sleep Apnea Syndrome，MSAS)， 3种类型中以阻塞型最为常见，中枢型一般不超过睡眠呼吸暂停综合征患者的10%，也有报道只有4%。目前把阻塞型和混合型两种类型统称为阻塞型睡眠呼吸暂停低通气综合征(Obstructive Sleep Apnea-Hypopnea Syndrome，OSAHS)。OSAHS是由于睡眠中上气道解剖性狭窄或生理性功能障碍，反复出现发作的咽部软组织塌陷、上气道阻塞为特征，导致低氧血症和睡眠结构改变的一种疾病，逐渐发展可出现肺动脉高压、肺心病、呼吸衰竭、高血压、心律失常、糖尿病、脑血管意外等严重并发症及至多脏器损伤，严重影响患者的生活质量和寿命，成为不稳定型心绞痛、心肌梗死、脑卒中的独立危险因素[1]。

缺氧是OSAHS病理变化的中心环节, 减轻缺氧导致的继发性损伤是疾病治疗的关键。……