【摘 要】
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目的 探讨重度肥胖合并重度阻塞型睡眠呼吸暂停低通气综合征(OSAHS)患者自动压力滴定治疗疗效.方法 回顾2013年12月-2016年3月在我院睡眠监测中心进行自动滴定的患者,其中睡眠呼吸暂停低通气指数(AHI)＞30次/h的重度男性OSAHS患者,并且体重指数(BMI)≥35kg/m2,共34例.中午进行面罩脱敏及1小时小睡滴定,晚间在睡眠中心进行整夜自动滴定.结果 其中1例午间滴定时不耐受,放
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目的 探讨重度肥胖合并重度阻塞型睡眠呼吸暂停低通气综合征(OSAHS)患者自动压力滴定治疗疗效.方法 回顾2013年12月-2016年3月在我院睡眠监测中心进行自动滴定的患者,其中睡眠呼吸暂停低通气指数(AHI)＞30次/h的重度男性OSAHS患者,并且体重指数(BMI)≥35kg/m2,共34例.中午进行面罩脱敏及1小时小睡滴定,晚间在睡眠中心进行整夜自动滴定.结果 其中1例午间滴定时不耐受,放弃持续正压通气治疗,1例于夜间滴定时不耐受,放弃.32例患者治疗后残余AHI较治疗前AHI明显改善,差异有统计学意义(P＜0.01),并且氧减指数(ODI)较治疗前明显降低,差异有统计学意义(P＜0.01),中午滴定后根据下载数据和同步睡眠监测结果设定下限压力的患者残余AHI较未设定下限压力(4cmH2O起始滴定)的患者残余AHI更低,但差异不具有统计学意义(p＞0.5),且治疗前AHI,最低血氧饱和度,嗜睡程度评分(ESS),BMI差异不具有统计学意义(p＞0.5).32例患者中16例自动单水平滴定,16例自动双水平滴定,两种滴定的患者90％治疗压力及残余AHI差异不具有统计学意义.结论 自动滴定在治疗重度肥胖合并重度OSAHS患者中具有很好的疗效；应用中午滴定,既可以进行面罩脱敏,适应性滴定,同时可以为夜间滴定提供最低压力设置的临床依据,从而提高疗效,方法简便宜行,设定有效压力范围,有效提高患者的疗效.
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