| 摘要: |
| 目的 探讨睡眠监测及上气道阻塞定位系统ApneaGraph 200(AG 200,JC Medical,美国)在阻塞性睡眠呼吸暂停低通气综合征(OSAHS)患者术前诊断疾病性质、病情严重程度及上气道阻塞平面定位中的应用价值。 方法 疑似OSAHS患者121例,均行Müller试验检查上气道阻塞部位,同步应用AG 200及十三导联睡眠监测(PSG; D-22525, Weinmann GmbH, 德国)进行整夜(7 h)睡眠监测。对比分析AG 200及PSG主要监测参数,包括呼吸暂停低通气指数(AHI)、平均动脉血氧饱和度(mean SaO2,MSaO2)、最低动脉血氧饱和度(lowest SaO2,LSaO2)、SaO2≤90%的累计时间占总监测时间的百分比(CT90%)及上气道阻塞性质和阻塞严重程度的诊断;将AG 200测定的各平面阻塞构成比与电子鼻咽喉镜的阻塞定位结果进行比较。 结果 AG 200测定的AHI、MSaO2、LSaO2、CT90%及对上气道阻塞性质和阻塞严重程度的诊断与PSG检测结果类似,差异均无统计学意义。上平面阻塞时,AG 200与电子鼻咽喉镜检查阳性率一致;下平面阻塞时,AG 200提示阳性率高于电子鼻咽喉镜检查结果(P <0.05)。 结论 AG 200与PSG同步监测可对OSAHS作出准确定性诊断和初步定位诊断。AG 200联合电子鼻咽喉镜检查可更准确地判断OSAHS上气道阻塞情况。 |
| 关键词: 睡眠呼吸暂停综合征 上气道测压法 上气道阻塞平面 多导睡眠监测 Müller试验 |
| DOI：10.3724/SP.J.1008.2015.00858 |
| 投稿时间：2015-02-19修订日期：2015-05-16 |
| 基金项目: |
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| Preoperative diagnosis value of sleep respiration monitoring and upper airway obstruction positioning system for patients with obstructive sleep apnea hypopnea syndrome |
| WEI Kai-xuan1,2Δ,QI Rong-xiang1Δ,SHI Song1,CHEN Shi-cai1* |
(1. Department of Otorhinolaryngology Head & Neck Surgery, Changhai Hospital, Second Military Medical University, Shanghai 200433, China;
2. Department of Traumatic Orthopedics, No. 153 Hospital of PLA, Zhengzhou 450001, Henan, China
△Co-first authors
*Corresponding author) |
| Abstract: |
| Objective To evaluate the preoperative value of the sleep respiration monitoring and upper airway obstruction positioning system ApneaGraph 200 (AG 200,JC Medical,America) in disease diagnosis (severity) and the location of upper airway obstruction plane in patients with obstructive sleep apnea hypopnea syndrome (OSAHS). Methods A total of 121 suspected patients with OSAHS were randomly selected. They were examined by Müller's maneuver in the upper airway obstruction site. Then they underwent one-night (7 h) sleeping monitor by polysomnography (PSG, D-22525, Weinmann GmbH, Germany) and AG 200 simultaneously. The data obtained by PSG and AG 200 were compared, including apnea-hypopnea index (AHI), mean arterial blood oxygen saturation (mean SaO2, MSaO2), lowest arterial oxygen saturation (lowest SaO2, LSaO2), percentage of the cumulative time of SaO2≤90% to total monitoring time (CT90%) and diagnosis of the properties and the severity of upper airway obstruction. The constituent ratios of the different obstructive plane measured by AG 200 and the upper airway obstructive sites determined by Müller's maneuver were also compared. Results The AHI, MSaO2, LSaO2, CT90% and the properties and the severity of upper airway obstruction by the AG 200 and PSG were similar. The positive rates of the upper plane obstructive sites determined by the endoscopy with Müller's maneuver and AG 200 were the same. The positive rate of the down plane obstructive sites determined by AG 200 was significantly higher than that determined by the endoscopy with Müller's maneuver (P <0.05). Conclusion One-night PSG and AG 200 monitoring can simultaneously achieve accurate qualitative and primary positioning diagnosis of OSAHS. AG 200 can identify the level of upper airway obstruction more accurately when combined with the endoscopy with Müller's maneuver. |
| Key words: sleep apnea syndromes manometry obstructive plane of upper airway polysomnography Müller's maneuver |
