目的 观察悬雍垂腭咽成形术联合经鼻持续气道正压(n-CPAP)治疗复杂性睡眠呼吸暂停综合征(ComSAS)的疗效.方法 选择2013年1月-2015年12月湖北省荆门市第一人民医院呼吸内科收治ComSAS患者60例作为研究对象,依照围手术期处理方式不同分成2组,各30例.2组均行悬雍垂腭咽成形术,联合鼻中隔矫正、下鼻甲低温等离子消融术,对照组手术全部患者均采用传统的常规治疗和护理方法,观察组在对照组基础上在术前1周及术后3d内行n-CPAP治疗,分别进行术前和术后1年的多导睡眠图(PSG)监测.结果 与对照组比较,观察组患者临床总有效率显著提高(x2=7.320,P＜0.05);2组患者治疗后各阶段REM比例、S3+S4、LSaO2、AHI均较治疗前显著改善,差异有统计学意义(P＜0.05);与对照组比较,观察组治疗后AHI下降,LSaO2明显升高,S3+S4比例和REM比例明显增高,差异均有统计学意义(p＜0.05).2组并发症发生均改善,且观察组改善情况优于对照组(P均＜0.05).结论 复杂性睡眠呼吸暂停综合征患者围术期采用正通气治疗有助于手术的顺利进行,能改善患者的手术疗效,手术方式简单可行.%Objective To explore the effect of uvulopalatopharyngoplasty combined with nasal continuous positive airway pressure (nCPAP) for the treatment of complex sleep apnea syndrome (ComSAS).Methods 60 cases of ComSAS patients in Jingmen First People's Hospital of Hubei from January 2013 to December 2015 were selected as the research object,they were divided into 2 groups according to the perioperative treatment,each group with 30 cases.The 2 groups underwent uvulopalatopharyngoplasty,combined with nasal septum and inferior turbinate low-temperature plasma ablation surgery control group,all patients were treated with conventional therapy and the traditional nursing method,the observation group on the basis of the control group in the 1 week before operation and within 3 d after nCPAP treatment,respectively,1 years ago and postoperative polysomnography.(PSG) monitoring were performed.Results Compared with the control group,the total effective rate of observation group increased significantly (x2 =7.32,P ＜ 0.05);the 2 groups of patients after treatment of the various stages of REM,S3 + S4,LSaO2,AHI ratio was significantly improved compared with before treatment,the difference was statistically significant (P ＜ 0.05);compared with the control group,the observation group after treatment,AHI decreased LSaO2 was significantly increased,S3 + S4 ratio and REM ratio were significantly increased,the differences were statistically significant (P ＜ 0.05).2 groups of complications were improved,and the observation group improved better than the control group (P ＜ 0.05).Conclusion Perioperative ventilation in patients with complex sleep apnea syndrome is conducive to the smooth operation,can improve the surgical effect of patients,the operation method is simple and feasible.
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