阻塞性睡眠呼吸暂停低通气综合征相关性高血压病的手术治疗

发布时间：2018-07-25 20:01

【摘要】：目的评价手术治疗阻塞性睡眠呼吸暂停低通气综合征(OSAHS)相关性高血压病的疗效。方法 OSAHS相关性高血压病患者102例,分别行鼻内镜鼻中隔黏膜下矫正术、鼻窦开放术、鼻息肉摘除术、韩式悬雍垂腭咽成形术等术式,手术前及术后3个月、6个月分别进行多导睡眠呼吸监测、24 h动态血压监测等检查;观察对比手术前与手术后3个月、6个月血压变化情况。结果手术治疗后3个月、6个月患者呼吸紊乱指数和呼吸暂停时间较术前下降、睡眠中最低血氧饱和度较术前升高(P0.05)。手术后3个月、6个月患者静息状态下的收缩压和舒张压、平均收缩压和舒张压均较术前下降(P0.05),手术后3个月和6个月静息状态下的收缩压和舒张压、平均收缩压和舒张压比较差异无统计学意义(P0.05),夜间平均收缩压和平均舒张压的下降更明显。经过手术治疗后的静息状态下血压恢复正常的患者58例,缓解率为52.9%(X~2=4.334,P0.01)。结论 OSAHS相关性高血压病患者手术后,睡眠呼吸暂停和低通气得到改善,同时收到良好降压效果。
[Abstract]:Objective to evaluate the effect of surgical treatment on (OSAHS) associated hypertension with obstructive sleep apnea hypopnea syndrome (OSAS). Methods 102 patients with OSAHS associated hypertension were treated with endoscopic submucosal correction of nasal septum, sinus surgery, nasal polyposis extraction, and Korean uvulopalatopharyngoplasty. 24 h ambulatory blood pressure monitoring was performed before operation and 3 months and 6 months after operation respectively, and the changes of blood pressure before operation and 3 months and 6 months after operation were observed and compared. Results after 3 months and 6 months of operation, the respiratory disorder index and apnea time were decreased, and the lowest oxygen saturation in sleep was higher than that before operation (P0.05). Systolic and diastolic blood pressure (SBP) and diastolic blood pressure (DBP) were decreased 3 months and 6 months after operation (P0.05), and systolic and diastolic blood pressure (DBP) in resting state 3 months and 6 months after operation. There was no significant difference between mean systolic blood pressure and diastolic blood pressure (P0.05). The decrease of night mean systolic blood pressure and mean diastolic blood pressure was more obvious. The remission rate was 52.9% in 58 patients whose blood pressure returned to normal after operation. Conclusion after operation, sleep apnea and hypopnea were improved in patients with OSAHS related hypertension.
【作者单位】：甘肃省人民医院甘肃睡眠医学中心;甘肃省永靖县人民医院耳鼻喉科;
【基金】：甘肃省卫生行业科研计划项目(GSWSKY2014-56) 天水市科技局项目(天财建[2014]389号)
【分类号】：R766.9;R544.1

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