持續(xù)氣道正壓通氣對合并阻塞性睡眠呼吸暫停綜合征的腦梗死患者平均氣道壓及神經功能的影響

打開文本圖片集

中圖分類號：R563，R743.3 文獻標志碼：A DOI：10.11958/20250596

Abstract： ObjectiveTo investigate the effcts continuous positive airway pressure （CPAP）on mean airway pressure and neurological function in cerebral infarction patients with obstructive sleep apnea-hypopneasyndrome （OSAS）. MethodsAtotal 245 patientswith cerebral infarctioncomplicated withOSAS （who received treatment inour hospital fromFebruary 2020toOctober 2023）werecolectedandstudiedbyprospectivestudy.Among them，52 patientsreceived basic intervention measures such as conventional drugs andrehabilitation therapy，and 93 patients received CPAPtherapyon thebasis basic intervention measures. Matching according to ： propensity score matching method，48 cases were dividedinto thecontrol group and 48 cases wereusedas theobservationgroup.The treatment periodthetwo groups was 4 days.Beforetreatment and after4days treatment，theoxygendesaturation index （ODI），lowestoxygensaturation （2號 （LSaO2） ，respiratory mechanics indexes [airwayresistance （Raw）， mean airway pressre （MPaw）and peak inspiratory preure （PIP）]，neurologicalfunctionscores[NationalInstiutesHealthStrokeScale（NSS）score，modifiedRankinasale（mR） scoreafter 3months]and Barthel index （BI）score werecomparedbetween the two groups，and theeficacyand the occurrence adversereactions wereevaluated.ResultsAfter4daystreatment，theODI，respiratory mechanics indexes Raw，MPaw，PIP，NIHSS score and mRS score were greatly reduced in the two groups，however， .5aO2 and BI score was increased （ P<0.05 ）.The ODI，Raw，MPaw，PIP，NIHSS score and mRS score were lower in the observation group than those the control group，while LSaO2 and BI score were higher in the observation group than those the control group （ P<0.05 ！ The total effective rate the observation group was higher than that the control group （ 87.5% Us. 68.8% ， P =0.026）. There was no significant difference in the incidence adverse reactions between the two groups （ P =0.673）. Conclusion CPAP is beneficialforreducingMPaw，improvingoxygensaturationandneurologicalfunction，and increasing totalefectiveatein patients with cerebral infarction combined with OSAS.It can be widely applied in clinical practice.

Key words： continuous positive airway pressure; sleep apnea， obstructive;brain infarction; mean airway pressure; neurological function

阻塞性睡眠呼吸暫停綜合征（OSAS）是指在睡眠過程中，由上呼吸道完全或部分阻塞引起的反復呼吸暫停和低通氣為特征的復雜性疾病，患者多表現(xiàn)為睡眠時發(fā)生呼吸暫停，并伴有缺氧、鼾聲、白天嗜睡等癥狀，目前臨床認為該病癥與上氣道解剖結構異常、上氣道擴張肌的擴張力降低、呼吸中樞調節(jié)異常等有關[]。（剩余9541字）