持续正压通气治疗急性脑梗死合并OSAHS疗效研究(1)
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[摘要] 目的 分析持续正压通气治疗急性脑梗死合并阻塞性睡眠呼吸暂停低通气综合征(OSAHS)的疗效，为临床更好地治疗该病提供指导性意见。方法 OSAHS患者78例，分为对照组37例和治疗组41例，进行夜间多导睡眠监测。结果 两组患者治疗前后NIHSS、收缩压、舒张压、AHI和最低血氧饱和度比较，差异有统计学意义(P<0.05)；治疗组治疗后NIHSS、收缩压、舒张压、AHI和最低血氧饱和度的改善程度明显优于对照组，差异有统计学意义(P<0.05)。结论 持续正压通气可以有效改善患者NIHSS、收缩压、舒张压、AHI和最低血氧饱和度。
[关键词] OSAHS；持续正压通气；美国国立卫生研究院卒中量表
[中图分类号] R766；R743.3 [文献标识码] B [文章编号] 1673-9701(2011)36-44-02
Efficacy of Continuous Positive Airway Pressure in the Treatment of Acute Cerebral Infarction with Obstructive Sleep Apnea-hypopnea Syndrome
GU Liang
Department of Respiratory Medicine，Zhejiang Hospital，Hangzhou 310013，China
[Abstract] Objective To analyze the efficacy of continuous positive airway pressure(CPAP) in the treatment of acute cerebral infarction with obstructive sleep apnea-hypopnea syndrome(OSAHS)，and provide opinions for better clinical treatment of this disease. Methods Seventy-eight patients with OSAHS were divided into control group (37 cases) and the treatment group (41 cases) for night polysomnography. Results The differences of NIHSS，systolic blood pressure，diastolic blood pressure，AHI and lowest oxygen saturation of two groups before and after treatment were statistically significant(P<0.05)；After treatment，improvement degrees of NIHSS，systolic blood pressure，diastolic blood pressure，AHI and lowest oxygen saturation of the treatment group were significantly better than those of the control group，and the differences were statistically significant(P<0.05). Conclusion CPAP can effectively improve NIHSS，systolic blood pressure，diastolic blood pressure，AHI and lowest oxygen saturation of OSAHS patients.
[Key words] Obstructive sleep apnea-hypopnea syndrome；Continuous positive airway pressure；NIH Stroke Scale
阻塞性睡眠呼吸暂停低通气综合征(obstructive sleep apnea-
hypopnea syndrome，OSAHS)以睡眠中间断性上呼吸道部分或全部梗阻为特点。直接发病机制是上气道的狭窄和阻塞，但OSAHS的发病并非简单的气道阻塞，还有呼吸中枢神经调节因素障碍，是引起急性脑梗死的重要危险因素之一。持续正压通气(continuous positive airway pressure，CPAP)可以有效治疗和改善OSAHS症状。
1 资料与方法
1.1 研究对象
选取2009年1月～2010年12月来我院神经内科住院治疗的78例急性脑梗死合并阻塞性睡眠呼吸暂停低通气综合征患者 ......
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