阻塞性睡眠呼吸暂停中的表皮质崩的潜在治疗方法:修改的药物诱导睡眠内镜如何帮助?
Hua-Wei Shih1, Yu-Lin Chen2, Hung-Che Lin3,4
1Department of Otolaryngology, Shin Kong Wu-Ho-Su memorial Hospital, Taipei City, Taiwan.
概括
头部旋转与闭嘴相结合,有效地治疗阻塞性睡眠呼吸暂停患者的前后后侧上垂体崩. 具有头部旋转的口腔器械也改善了侧面表皮节塌,提供了新的治疗选择.
科学领域:
- 睡眠医学 睡眠医学
- 耳鼻喉科 耳鼻喉科 耳鼻喉科
- 呼吸系统医学 呼吸系统医学
背景情况:
- 阻塞性睡眠呼吸暂停 (OSA) 是一种常见的疾病,其特点是睡眠期间重复出现上呼吸道崩.
- 表皮膜崩 (EC) 是标准OSA治疗失败的重要原因,如持续正气道压力 (CPAP) 和uvulopalatopharyngoplasty.
- 确定EC的有效治疗方法对于改善患者的治疗结果至关重要.
研究的目的:
- 调查各种干预措施在阻塞性睡眠呼吸暂停 (OSA) 患者的表皮质收缩 (EC) 管理中的有效性.
- 评估使用药物诱导睡眠内镜与目标控制输液 (TCI-DISE) 治疗前后后表皮收缩 (apEC) 和侧面表皮收缩 (latEC) 的治疗方法.
主要方法:
- 在高等教育中心进行的回顾性队列研究.
- 选了352名接受TCI-DISE (2016-2022) 的OSA患者;分析了54名EC患者.
- 在TCI-DISE期间,通过包括头部旋转,闭口,口腔器械 (OA) 和间歇性负气道压力 (iNAP) 在内的干预措施评估了EC严重程度.
主要成果:
- 旋转头部和闭嘴显著降低了apEC严重程度,分别在60.0%和53.6%的患者中.
- 综合干预显示出更高的疗效:头部旋转与闭口改善了77.8%的患者的APEC.
- 有头部旋转的口腔器械对latEC有效,在61.5%的患者中改善了严重程度.
结论:
- 头部旋转与闭嘴是通过TCI-DISE发现的apEC最有效的治疗方法.
- 与apEC相比,患有latEC的患者往往具有更高的BMI和呼吸暂停-呼吸暂停指数.
- 口服器械的使用与头部旋转相结合,在OSA患者治疗latEC方面显示出有前途.
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