功能保全性声门癌手术患者睡眠呼吸状况的观察
发布时间：2018-08-21 07:39
【摘要】：目的:探讨声门癌患者手术前和功能保全性声门癌手术后睡眠呼吸紊乱的状况,以及功能保全性声门癌手术的不同术式对患者睡眠呼吸紊乱的影响。方法:采用便携式多导睡眠监测仪对未经任何治疗的66例声门癌患者和已行功能保全性声门癌手术并拔除气管套管6月以上的58例声门癌患者进行阻塞性睡眠呼吸暂停低通气综合征(obstrucive sleep apnea hypopnea syndrome,OSAHS)筛查;参照标准为中华耳鼻咽喉头颈外科杂志编委会和中华医学会耳鼻咽喉头颈外科分会咽喉学组(2009)制定的《阻塞性睡眠呼吸暂停低通气综合征诊断和外科治疗指南》;对功能保全性声门癌手术后患者按照手术切除喉部软骨支架等重要结构范围的不同分为手术范围较大组和手术范围较小组两组;按照上述指南以呼吸暂停低通气指数(apnea-hypopnea index,AHI)为标准对OSAHS病情进行评判,以最低血氧饱和度(the lowest blood oxygen saturation,LSa O2)判断低氧血症程度;对所得结果进行统计分析。结果:(1)未经治疗的声门癌患者66例中符合OSAHS诊断标准者38例(57.57%),58例功能保全性声门癌手术后患者中符合OSAHS诊断标准者32例(55.17%),两组比较差异无统计学意义(X2=0.073,P0.05);66例未经治疗的声门癌患者中符合重度OSAHS者2例(3.03%),功能保全性声门癌手术患者58例中符合重度OSAHS者8例(13.79%),两组比较差异有统计学意义(X2=4.823,P0.05);(2)功能保全性声门癌手术后患者中,手术范围较大组18例中符合OSAHS诊断标准者14例(77.78%),手术范围较小组患者40例中符合OSAHS诊断标准者18例(45.00%),两组比较差异有统计学意义(X2=5.393,P0.05);手术范围较大组18例中符合中、重度OSAHS诊断标准者10例(55.56%),手术范围较小组40例中符合中、重度OSAHS诊断标准者10例(25.00%),两组比较差异有统计学意义(X2=5.130,P0.05)。结论:(1)未经治疗的声门癌患者OSAHS患病率较高;(2)功能保全性手术后的声门癌患者具有较高的OSAHS患病率,术后OSAHS的严重程度较未手术者有所加重;对喉结构破坏范围较大的功能保全性手术后的声门癌患者OSAHS的程度较重;未经治疗的和功能保全性手术后的声门癌患者的睡眠呼吸障碍值得重视。
[Abstract]:Objective: to investigate the status of sleep apnea disorder in patients with glottic carcinoma before and after operation. Methods: 66 patients with glottic cancer without any treatment and 58 patients with glottic carcinoma who had been operated on and tracheal cannula removed for more than six months were treated with a portable polysomnography. (obstrucive sleep apnea hypopnea syndromesia OSAHS screening; The standard of reference was the "guidelines for the diagnosis and surgical treatment of obstructive sleep apnea hypopnea syndrome" developed by the editorial Committee of the Chinese Journal of Otolaryngology and head and neck surgery of Otolaryngology and the pharyngopharyngology Group of the Otolaryngology Branch of the Chinese Medical Association (2009). Patients with functionally safe glottic carcinoma were divided into two groups according to the different range of important structures such as resection of laryngochondral stents. According to the above guidelines, the apnea-hypopnea index of hypopnea (apnea-hypopnea index AHI) was used to judge the condition of OSAHS, and the lowest oxygen saturation (the lowest blood oxygen saturation) was used to judge the degree of hypoxemia, and the results were statistically analyzed. Results: (1) of 66 patients with untreated glottic carcinoma, 38 (57.57%) met the OSAHS diagnostic criteria. 32 (55.17%) of 58 patients with functionally safe glottic carcinoma met the diagnostic criteria of OSAHS (55.17%). There was no significant difference between the two groups (X2 / 0.073, P0.05) in 66 untreated patients. There were 2 cases (3.03%) with severe OSAHS in glottic carcinoma and 8 cases (13.79%) with severe OSAHS in 58 patients with functionally safe glottic carcinoma. The difference between the two groups was statistically significant (X24.823 p0.05); (2). In the larger group, 14 cases (77.78%) met the diagnostic criteria of OSAHS, and 18 cases (45.00%) met the diagnostic criteria of OSAHS in comparison with the group of 40 patients. The difference between the two groups was statistically significant (X25.393P 0.05), and in the larger group of 18 cases, the range of operation was in accordance with the standard of OSAHS (45.00%). There were 10 cases (55.56%) with severe OSAHS, 10 cases (25.00%) with severe OSAHS and 10 cases (25.00%) with moderate or severe OSAHS. The difference between the two groups was statistically significant (P 0.05). Conclusion: (1) the prevalence of OSAHS in patients with untreated glottic carcinoma is higher than that in patients with untreated glottic carcinoma. (2) the incidence of OSAHS in patients with glottic carcinoma after functional preservation surgery is higher than that in patients without operation, and the severity of OSAHS after operation is more serious than that in patients without operation. The degree of OSAHS in patients with glottic carcinoma after laryngeal structure preservation surgery is more serious, and sleep apnea disorder in patients with glottic carcinoma after untreated and functional preservation surgery is worthy of attention.
【学位授予单位】：青岛大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R739.6
本文编号：2195018
[Abstract]:Objective: to investigate the status of sleep apnea disorder in patients with glottic carcinoma before and after operation. Methods: 66 patients with glottic cancer without any treatment and 58 patients with glottic carcinoma who had been operated on and tracheal cannula removed for more than six months were treated with a portable polysomnography. (obstrucive sleep apnea hypopnea syndromesia OSAHS screening; The standard of reference was the "guidelines for the diagnosis and surgical treatment of obstructive sleep apnea hypopnea syndrome" developed by the editorial Committee of the Chinese Journal of Otolaryngology and head and neck surgery of Otolaryngology and the pharyngopharyngology Group of the Otolaryngology Branch of the Chinese Medical Association (2009). Patients with functionally safe glottic carcinoma were divided into two groups according to the different range of important structures such as resection of laryngochondral stents. According to the above guidelines, the apnea-hypopnea index of hypopnea (apnea-hypopnea index AHI) was used to judge the condition of OSAHS, and the lowest oxygen saturation (the lowest blood oxygen saturation) was used to judge the degree of hypoxemia, and the results were statistically analyzed. Results: (1) of 66 patients with untreated glottic carcinoma, 38 (57.57%) met the OSAHS diagnostic criteria. 32 (55.17%) of 58 patients with functionally safe glottic carcinoma met the diagnostic criteria of OSAHS (55.17%). There was no significant difference between the two groups (X2 / 0.073, P0.05) in 66 untreated patients. There were 2 cases (3.03%) with severe OSAHS in glottic carcinoma and 8 cases (13.79%) with severe OSAHS in 58 patients with functionally safe glottic carcinoma. The difference between the two groups was statistically significant (X24.823 p0.05); (2). In the larger group, 14 cases (77.78%) met the diagnostic criteria of OSAHS, and 18 cases (45.00%) met the diagnostic criteria of OSAHS in comparison with the group of 40 patients. The difference between the two groups was statistically significant (X25.393P 0.05), and in the larger group of 18 cases, the range of operation was in accordance with the standard of OSAHS (45.00%). There were 10 cases (55.56%) with severe OSAHS, 10 cases (25.00%) with severe OSAHS and 10 cases (25.00%) with moderate or severe OSAHS. The difference between the two groups was statistically significant (P 0.05). Conclusion: (1) the prevalence of OSAHS in patients with untreated glottic carcinoma is higher than that in patients with untreated glottic carcinoma. (2) the incidence of OSAHS in patients with glottic carcinoma after functional preservation surgery is higher than that in patients without operation, and the severity of OSAHS after operation is more serious than that in patients without operation. The degree of OSAHS in patients with glottic carcinoma after laryngeal structure preservation surgery is more serious, and sleep apnea disorder in patients with glottic carcinoma after untreated and functional preservation surgery is worthy of attention.
【学位授予单位】：青岛大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R739.6
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