Efficacy of Modified Uvulopalatopharyngoplasty in the Treatment of OSAHS Patients with Cognitive Impairment and Its Effect on Respiratory Function, Electroencephalogram and MMSE Score
ZHU Yubo, CHENG Leilei, ZHU Rongfei, et al
Ya'an People's Hospital, Sichuan Ya'an 625000, China
Abstract：Objective: To observe the curative effect of modified uvulopalatopharyngoplasty (H-UPPP) in the treatment of patients with obstructive sleep apnea hypopnea syndrome (OSAHS) with cognitive impairment and the effects on respiratory function, electroencephalogram and Montreal cognitive assessment scale ( MMSE) score. Methods: A total of 124 patients with moderate and severe OSAHS and cognitive impairment who were admitted to the Department of Otolaryngology, Head and Neck Surgery of Ya'an People's Hospital from February 2020 to February 2022 were selected as the research subjects. They were divided into two groups by simple random method, 62 patients in each group. The conservative group was treated with behavioral therapy intervention, and the observation group was treated with H-UPPP combined with behavioral therapy intervention. The differences of polysomnography parameters, Montreal Cognitive Assessment Scale (MOCA) score, Sleep Assessment Scale (ESS) score, LMT Delayed Recall (LMT DR) score, Rey Osterlieth Complex Graph Test (CFT), Logical Memory Test (LMT), CFT Delayed Recall (CFT DR) score, MMSE score and P300 latency between the two groups were compared, and the abnormal rate and total effective rate of EEG in the two groups after 6 months were counted. Results: The apnea hypopnea index (AHI) decreased and LSpO2 increased in conservative group after 6 months of treatment (P<0.05). After 6 months of treatment, AHI and SaO2<90% accounted for the percentage of total monitoring time (TS90%) and (N1+N2) % in the observation group decreased, while LSpO2, N3% and REM sleep period accounted for the percentage of total monitoring time (REM%) increased (P<0.05). The differences of AHI, LSpO2, TS90%, (N1+N2) %, N3% and REM% before and after treatment in observation group were higher than those in conservative group (P<0.05). ESS score in conservative group decreased after 6 months of treatment (P<0.05). After 6 months of treatment, ESS score decreased, MMSE score and MOCA score increased in observation group (P<0.05). The ESS score of observation group was lower than that of conservative group after 6 months of treatment (P<0.05). There was no significant difference in CFT, LMT, and delayed recall scores in the conservative group after 6 months of treatment compared with those before treatment (P>0.05). After 6 months of treatment, the LMT score and the LMT DR Score in the observation group were higher than before, but there was no statistical significance in CFT score and CFT DR Score compared with before treatment (P>0.05). The difference of MMSE score, MOCA score and ESS score before and after treatment in observation group was higher than that in conservative group (P<0.05). There was no significant difference in P300 incubation period in the conservative group after 6 months of treatment compared with before treatment (P>0.05). After 6 months of treatment, the latency of P300 at Fz, Cz, Pz and C4 points decreased, but there was no significant difference in the latency of P300 at C3 points compared with before treatment (P>0.05). The difference of P300 latency before and after treatment in observation group was higher than that in conservative group (P<0.05). After 6 months, the abnormal rate of EEG in the observation group was 24.19% (15/62), which was significantly lower than that in the conservative group (50.00% (31/62), and the total effective rate was 88.71% (55/62), which was significantly higher than that in the conservative group (56.45% (35/62), with statistical difference (P>0.05).Conclusion: Modified uvulopalatopharyngoplasty in the treatment of OSAHS with cognitive impairment can effectively improve the sleep structure and EEG activity status of patients, and is conducive to the recovery of cognitive function of patients.
朱玉博, 程蕾蕾, 朱荣飞, 刘秋蕊, 徐艳红. 改良悬雍垂腭咽成形术治疗OSAHS伴认知功能障碍患者疗效及对呼吸功能脑电图和MMSE评分的影响[J]. 河北医学, 2023, 29(9): 1543-1548.
ZHU Yubo, CHENG Leilei, ZHU Rongfei, et al. Efficacy of Modified Uvulopalatopharyngoplasty in the Treatment of OSAHS Patients with Cognitive Impairment and Its Effect on Respiratory Function, Electroencephalogram and MMSE Score. HeBei Med, 2023, 29(9): 1543-1548.
2023, Vol. 29 
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