持续气道正压通气对合并阻塞性睡眠呼吸暂停综合征的脑梗死患者平均气道压及神经功能的影响
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中图分类号：R563，R743.3 文献标志码：A DOI：10.11958/20250596
Abstract： ObjectiveTo investigate the effcts continuous positive airway pressure （CPAP）on mean airway pressure and neurological function in cerebral infarction patients with obstructive sleep apnea-hypopneasyndrome （OSAS）. MethodsAtotal 245 patientswith cerebral infarctioncomplicated withOSAS （who received treatment inour hospital fromFebruary 2020toOctober 2023）werecolectedandstudiedbyprospectivestudy.Among them，52 patientsreceived basic intervention measures such as conventional drugs andrehabilitation therapy，and 93 patients received CPAPtherapyon thebasis basic intervention measures. Matching according to ： propensity score matching method，48 cases were dividedinto thecontrol group and 48 cases wereusedas theobservationgroup.The treatment periodthetwo groups was 4 days.Beforetreatment and after4days treatment，theoxygendesaturation index （ODI），lowestoxygensaturation （2号 （LSaO2） ，respiratory mechanics indexes [airwayresistance （Raw）， mean airway pressre （MPaw）and peak inspiratory preure （PIP）]，neurologicalfunctionscores[NationalInstiutesHealthStrokeScale（NSS）score，modifiedRankinasale（mR） scoreafter 3months]and Barthel index （BI）score werecomparedbetween the two groups，and theeficacyand the occurrence adversereactions wereevaluated.ResultsAfter4daystreatment，theODI，respiratory mechanics indexes Raw，MPaw，PIP，NIHSS score and mRS score were greatly reduced in the two groups，however， .5aO2 and BI score was increased （ P<0.05 ）.The ODI，Raw，MPaw，PIP，NIHSS score and mRS score were lower in the observation group than those the control group，while LSaO2 and BI score were higher in the observation group than those the control group （ P<0.05 ！ The total effective rate the observation group was higher than that the control group （ 87.5% Us. 68.8% ， P =0.026）. There was no significant difference in the incidence adverse reactions between the two groups （ P =0.673）. Conclusion CPAP is beneficialforreducingMPaw，improvingoxygensaturationandneurologicalfunction，and increasing totalefectiveatein patients with cerebral infarction combined with OSAS.It can be widely applied in clinical practice.
Key words： continuous positive airway pressure; sleep apnea， obstructive;brain infarction; mean airway pressure; neurological function
阻塞性睡眠呼吸暂停综合征（OSAS）是指在睡眠过程中，由上呼吸道完全或部分阻塞引起的反复呼吸暂停和低通气为特征的复杂性疾病，患者多表现为睡眠时发生呼吸暂停，并伴有缺氧、鼾声、白天嗜睡等症状，目前临床认为该病症与上气道解剖结构异常、上气道扩张肌的扩张力降低、呼吸中枢调节异常等有关[]。（剩余9541字）