患者转诊和接受大巴进步对于阻塞性睡眠呼吸暂停
Julianna Rodin1, Michele Fiorella1, Meghan Crippen1
1Department of Otolaryngology-Head and Neck Surgery, Thomas Jefferson University Hospitals, Philadelphia, Pennsylvania, U.S.A.
The Laryngoscope
|November 6, 2023
概括
很少有患者因阻塞性睡眠呼吸暂停 (OSA) 被转诊为上 (MMA) 进行手术. 许多患者由于对侵入性和恢复的担忧而避免MMA,有些人选择恢复CPAP.
科学领域:
- 睡眠呼吸暂停的手术治疗方法
- 口腔和大面部外科手术
- 睡眠的药物 睡眠的药物
背景情况:
- 上部推进 (MMA) 是阻塞性睡眠呼吸暂停 (OSA) 的一个有效的外科选择.
- 患者坚持持续正气道压力 (CPAP) 可能是具有挑战性的.
- 了解MMA的转诊模式和外科手术采用是至关重要的.
研究的目的:
- 确定MMA转诊患者的随访率.
- 确定为什么被转诊为MMA的患者不进行手术的原因.
- 分析患者在MMA转诊后对OSA治疗的选择.
主要方法:
- 回顾性审查OSA患者不耐受CPAP,他们接受了药物诱导睡眠内镜 (DISE).
- 根据DISE和其他发现,包括推MMA的患者.
- 通过IRB批准的调查与患者联系,以收集后续和决策数据.
主要成果:
- 只有48%的被转诊为MMA的患者接受了口腔大面部手术 (OMFS),而18%的患者接受了手术.
- 对手术侵入性 (39%) 和恢复时间 (17%) 的担忧是不继续MMA的主要原因.
- 在没有接受MMA的患者中,28.6%的人没有使用任何OSA治疗.
结论:
- 不到一半的被转诊为MMA咨询的患者最终接受手术.
- 患者对手术过程和康复的担忧显著影响了MMA的吸收.
- 值得注意的是,在转诊后,有很大比例的患者要么不进行随访,要么选择退出MMA,这凸显了OSA治疗坚持的差距.
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