北京大学学报(医学版) ›› 2020, Vol. 52 ›› Issue (2): 281-284. doi: 10.19723/j.issn.1671-167X.2020.02.014
Bing-wan DONG,Jun-bo ZHANG,Shui-fang XIAO()
摘要:
目的 探讨阻塞性睡眠呼吸暂停低通气综合征(obstructive sleep apnea hypopnea syndrome,OSAHS)患者术前病史及查体等资料,联合术后早期睡眠血氧结果,对悬雍垂腭咽成形术(uvulopalatopharyngoplasty,UPPP)疗效的预测价值.方法: 选择2013年1月至2016年5月于北京大学第一医院接受UPPP手术治疗且有完整随访资料的患者进行回顾性研究,搜集包括年龄,查体及睡眠监测等资料,所有患者在术后早期(1周)均实施主观疗效评估及整夜脉氧监测,术后长期疗效评估进行至少术后3个月的睡眠监测及视觉模拟量表评估.结果: 共纳入61 例患者,完成随访后有效者25 例(41.0%), 无效者36 例(59.0%), 回归分析发现术后早期≥4%的氧降指数(the oxygen index of ≥4%,ODI4)及术前Friedman分型是疗效的独立预测参数(P<0.05),ROC曲线分析术后早期ODI4对疗效的预测效率,发现曲线下面积可达0.822,以15作为界值,敏感性和特异性分别可达0.778和0.760,其中ODI4<15 次/h的患者有效率可达70.4%,显著高于ODI4≥15 次/h的患者,即17.6%(P<0.05);术前Friedman分型Ⅱ型患者中,ODI4<15次/h的患者,其有效率显著高于ODI4≥15 次/h的患者(87.5% vs. 25.0%),Ⅲ型患者中亦可得到类似的结果(33.3% vs. 6.7%).结论: 通过对UPPP术后早期脉氧监测数据尤其是ODI4的收集,结合术前的Friedman分型,能更好地判断患者潜在的手术疗效.
中图分类号:
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