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

doi:10.3969/j.issn.1006-6233.2023.09.024

Abstract
Figure/Table
References
Related Citation (15)

Download: PDF (1196 KB) HTML (1 KB)
Export: BibTeX | EndNote (RIS)

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.

Key words： Modified uvulopalatopharyngoplasty Obstructive sleep apnea hypopnea syndrome Cognitive dysfunction Sleep structure EEG activity status Respiratory function

	Service

	E-mail this article
	Add to my bookshelf
	Add to citation manager
	E-mail Alert
	RSS
	Articles by authors

Cite this article:

URL:

http://www.hbyxzzs.cn/EN/10.3969/j.issn.1006-6233.2023.09.024 OR http://www.hbyxzzs.cn/EN/Y2023/V29/I9/1543

[1] Muhafiz,Ersin,Olcen,et al.Evaluation of meibomian glands in obstructive sleep apnea-hypopnea syndrome[J].Cornea,2020,39(6):685-690.
[2] 杜莉,熊小花,段芳芳,等.海南省成人阻塞性睡眠呼吸暂停低通气综合征患者无创正压通气治疗接受情况及其影响因素分析[J].中国全科医学,2022,25(27):3414-3421.
[3] 黄一苇,张昊,李灵真.成年OSAHS患者血清MIF水平与病情严重程度的相关性及对并发脑梗死的预测价值[J].分子诊断与治疗杂志,2020,12(4):464-468.
[4] 许镇斌,杨小雄,庄燕云,等.OSAHS患者应用改良悬雍垂腭咽成形术治疗的效果观察[J].国际医药卫生导报,2022,28(12):1656-1660.
[5] 中华医学会呼吸病学分会睡眠呼吸障碍学组.阻塞性睡眠呼吸暂停低通气综合征诊治指南(2011年修订版)[J].中华结核和呼吸杂志,2012,35(1):9-12.
[6] 周小炫,谢敏,陶静,等.简易智能精神状态检查量表的研究和应用[J].中国康复医学杂志,2016,31(6):694-696,706.
[7] 张立秀,刘雪琴.蒙特利尔认知评估量表中文版的信效度研究[J].护理研究,2007,21(31):2906-2907.
[8] 李国平,金前,许雯,等.Epworth嗜睡量表和颈围对阻塞性睡眠呼吸暂停低通气综合征患者病情评估的意义[J].浙江临床医学,2013(10):1469-1470,1471.
[9] 曹歆轶,郭起浩,洪震.Rey-Osterrieth复杂图形再认测验在检测阿尔兹海默病中的应用研究[M].中华医学会第十三次全国神经病学学术会议论文汇编,2010.
[10] Francesco Missale,Marco Fragale,Fabiola Incela,et al.Outcome predictors for non-resective pharyngoplasty alone or as a part of multilevel surgery,in obstructive sleep apnea-hypopnea syndrome[J].Sleep & breathing =:Schlaf & Atmung,2020,24(4):1397-1406.
[11] 侯炜,许映龙,高天喜.改良悬雍垂腭咽成形术联合鼻部同期手术对重度阻塞性睡眠呼吸暂停低通气综合征的疗效分析[J].川北医学院学报,2020,35(1):100-102,117.
[12] 李云霞,彭琨,李俊彤,等.3D-ASL在中重度OSAHS患者脑血流灌注及认知功能改变的应用研究[J].中国医学计算机成像杂志,2022,28(1):13-18.