摘要
目的探讨持续气道正压通气(CPAP)治疗对合并阻塞性睡眠呼吸暂停低通气综合征(OSAHS)的重症高血压脑出血患者术后康复的影响。方法收集2009年1月至2011年12月济宁医学院附属医院神经外科及后期转入康复科住院的患者80例。采用随机分组,对照组(40例)采用常规治疗,治疗组(40例)在常规治疗基础上进行CPAP治疗,记录两组患者治疗前后呼吸参数的变化,检测术前术后不同时相的血清C反应蛋白(CRP)、肿瘤坏死因子-α(TNF-α)水平,并进行配对t检验分析,进而评估患者的近期预后。结果两组在分别治疗7 d后,治疗组呼吸暂停明显减少,低氧发作次数明显减少,SaO2明显提高;对照组呼吸暂停指数无明显改善,两组治疗后比较差异有统计学意义(t=16.1734、22.9401、16.4622,P均<0.05)。治疗后第3天、第7天、第14天,CPAP治疗组的患者血清CRP、TNF-α升高幅度明显低于对照组(P<0.05,P<0.01);同时经CPAP治疗患者的临床疗效评定总有效率明显优于对照组(87.5%、72.5%,P<0.01)。结论积极的CPAP治疗,可以有效降低合并OSAHS的重症高血压脑出血术后患者的炎性反应,从而显著改善患者的神经功能康复水平。
Objective To explore the severe hypertensive intracerebral hemorrhage patients combined with sleep apnea hypopnea syndrome(OSAHS)by application of continuous positive airway pressure(CPAP),and investigate the impact of rehabilitation.Methods Eighty patients in Department of Neurosurgery of Afficiated Hospital of Jining Medieal College from January 2009 to December 2011 were involved in the study.The patients were randomly divided into control group(n=40)and treatment group(n=40).The respiratory parameters before and after treatment were recorded.The serum C reaction protein(CRP)and tumor necrosis factor α(TNF-α)were detected before and after therapy,and the differences were analyzed by t test.Patient' s prognosis was assessed.Results The breathing pause and hypoxic attack reduced,the SaO2improved significantly in the treatment group.While,there was no changes of apnea index in the control group.The difference was significant(t=16.1734,22.9401,16.4622,P<0.05).At 3rd,7th,14th days after treatment,the serum CRP,TNF-α increased significantly lower in CPAP therapy group than the control group(P<0.05,P<0.01); while clinical efficacy assessment results was significantly better than the control group(87.5% vs.72.5%,P<0.01).Conclusion Positive CPAP treatment can reduce the inflammatory response of severe hypertensive cerebral hemorrhage postoperative combined with OSAHS patients,thus it improves the patient's neurological rehabilitation significantly.
出处
《中华脑科疾病与康复杂志（电子版）》
2012年第2期107-110,共4页
Chinese Journal of Brain Diseases and Rehabilitation（Electronic Edition）
基金
山东省济宁市医药卫生科技项目(济科字[2011]57号Ⅱ-5)
关键词
脑出血
睡眠呼吸暂停
阻塞性
连续气道正压通气
C反应蛋白
肿瘤坏死因子Α
Cerebral hemorrhage
Sleep apnea,obstructive
Continuous positive airway pressure
C-reactive protein
Tumor necrosis factor-alpha
