睡眠障碍干预对接受实体器官移植的阻塞性睡眠呼吸暂停患者的影响:系统性审查
Bijal Desai1, Xiaole Li1, Joshua Andrusiak1
1From the Department of Anesthesiology and Pain Medicine, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada.
Anesthesia and analgesia
|August 8, 2025
概括
持续的正气道压力 (CPAP) 可能会改善固体器官移植患者的睡眠质量,这些患者有阻塞性睡眠呼吸暂停 (OSA). 然而,它对长期存活的影响尚不清楚,需要进一步研究.
科学领域:
- 移植医学 移植医学 移植医学
- 睡眠医学 睡眠医学
- 肺部病理学 肺部病理学
背景情况:
- 睡眠不足和阻塞性睡眠呼吸暂停 (OSA) 在实体器官移植 (SOT) 受体中很常见.
- OSA与各种不良健康结果有关.
研究的目的:
- 系统地审查OSA疗法的影响,特别是持续正气道压力 (CPAP),对SOT患者的结果.
- 综合当前关于SOT人口中CPAP有效性的证据.
主要方法:
- 在PROSERO注册的系统审查 (CRD42024512577) 并按照PRISMA指南报告.
- 在多个数据库中进行了搜索 (MEDLINE,Embase,Cochrane,CINAHL,PsycINFO).
- 包括成年SOT患者与OSA;从符合条件的研究中提取数据.
主要成果:
- 只有3项研究符合资格标准,1项专注于心脏移植患者.
- 在一项研究中,CPAP改善了睡眠参数 (呼吸暂停-呼吸暂停指数,兴奋指数,总睡眠时间).
- 未经治疗的OSA与早期的移植功能障碍有关.
- CPAP对1年死亡率或5年生存率没有显著影响.
结论:
- 有限的证据表明,CPAP可能有利于SOT患者的睡眠质量.
- 需要进一步的研究,包括随机对照试验 (RCT),以评估CPAP的耐受性,遵守性和有效性.
- 针对个体患者需求量身定制的优化睡眠干预措施对SOT接受者至关重要.
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