OSAHS患者清醒和睡眠状态下阻塞平面的VOTE评分比较

发布时间：2018-06-10 13:21

  本文选题：睡眠呼吸暂停低通气综合征 + 阻塞性　； 参考：《临床耳鼻咽喉头颈外科杂志》2017年12期

【摘要】：目的:比较OSAHS患者清醒和睡眠状态时上气道阻塞情况的VOTE评分。方法:经多导睡眠监测诊断为OSAHS的患者40例,分别进行清醒时Müller's检查及药物诱导睡眠内镜检查(DISE),并录像记录检查结果。统一使用VOTE评分系统描述检查过程中所观察到上气道的阻塞平面、阻塞程度及阻塞形态,比较两种检查结果的差异,并比较不同阻塞程度的患者间BMI、AHI、最低血氧饱和度及平均血氧饱和度是否存在差异。结果:清醒状态的Müller's检查主要观察到腭咽平面及口咽侧壁平面的阻塞,完全阻塞率分别为52.5%和30.0%。DISE结果提示40例OSAHS患者主要的上气道阻塞部位仍在腭咽平面,以完全阻塞为主(90.0%),其中以环形阻塞(95.0%)最为常见。口咽侧壁完全阻塞率为60.0%,舌根完全阻塞率为17.5%。根据VOTE评分,40例患者DISE检查在腭咽、口咽侧壁、舌根及会厌平面上的得分均高于清醒状态的Müller's检查,均差异有统计学意义(P0.05)。Müller's检查中,各平面不同阻塞程度患者间的BMI、AHI、最低血氧饱和度及平均血氧饱和度均无统计学差异(P0.05)。DISE检查结果中,腭咽平面,部分阻塞患者与完全阻塞患者的AHI值及最低血氧饱和度差异有统计学意义(P0.05);口咽侧壁、舌根及会厌平面,不同阻塞程度的患者间上述指标均无统计学差异(P0.05)。结论:OSAHS患者DISE检查VOTE评分明显高于Müller's检查,睡眠状态的上气道阻塞平面更多,阻塞程度更重。BMI、AHI、最低血氧饱和度及平均血氧饱和度与VOTE评分中的阻塞严重程度关联不明显。
[Abstract]:Objective: to compare the VOTE score of upper airway obstruction in patients with OSAHS. Methods: forty patients with OSAHS diagnosed by polysomnography were examined with M 眉 ller's and DISEN respectively, and the results were recorded by video recording. VOTE scoring system was used to describe the obstruction plane, degree and shape of the upper airway, and the difference between the two results was compared. The differences of BMIAHI, minimum oxygen saturation and mean oxygen saturation between patients with different degrees of obstruction were compared. Results: M 眉 ller's in awake state mainly observed the obstruction of palatopharynx plane and oropharynx lateral wall plane. The complete obstruction rate was 52.5% and 30.0.DISE respectively. The results showed that the main upper airway obstruction site of 40 patients was still in the palatopharynx level. The most common is complete obstruction (90.0%) and annular obstruction (95.0%). The complete obstruction rate of lateral wall of oropharynx and tongue root was 60. 0 and 17. 5% respectively. According to the score of VOTE, the scores of dis in palatopharynx, lateral wall of oropharynx, tongue root and epiglottis were higher than those in M 眉 ller's in awake state. The difference was statistically significant in the examination of palatopharynx, lateral wall of oropharynx, root of tongue and ller's of epiglottis. There was no significant difference in BMIAHI, minimum oxygen saturation and mean oxygen saturation among patients with different degrees of obstruction at different levels. The palatopharynx level was found in the results of P0.05U .DISE. There was significant difference in AHI value and minimum oxygen saturation between patients with partial obstruction and those with complete obstruction (P 0.05), but there was no significant difference between patients with oropharynx lateral wall, tongue root, epiglottis level and different degree of obstruction. Conclusion the score of VOTE in the patients with OSAHS was significantly higher than that in M 眉 ller's. The obstructive level of upper airway was higher and the degree of obstruction was more severe in sleep. The lowest oxygen saturation and mean oxygen saturation were not correlated with the severity of occlusion in VOTE score.
【作者单位】： 南方医科大学南方医院耳鼻咽喉科;
【基金】：广东省自然科学基金博士启动项目(No:2015A030310049)
【分类号】：R766
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本文编号：2003364