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目的探讨夜间脉搏-氧饱和度仪在睡眠呼吸暂停低通气综合征(SAHS)治疗中的临床应用价值。方法对44例SAHS患者治疗前后进行夜间动态血氧饱和度(SaO2)监测,对治疗前后夜间各项动态血氧监测指标[氧减饱和指数(ODI4),最低血氧饱和度(LSaO2),平均血氧饱和度(MSaO2),血氧饱和度低于90%的时间占睡眠总时间的百分比(SIT90)]进行比较。35例患者在中午进行家庭自动持续气道正压通气(CPAP)压力滴定,9例在夜间进行家庭自动CPAP压力滴定。结果治疗前、后血氧监测指标(ODI4、LsaO2、MsaO2和SIT90)各组间比较差异有显著性(P均<0.01)。大多数患者经2~3天调压获得成功。结论SIT90、LSaO2、MSaO2和ODI4等指标可以较好地反映无创正压气道通气的治疗效果,应用脉搏-氧饱和度监测指导呼吸机压力滴定,方法简便而实用,费用低,便于家庭操作。
Objective To investigate the clinical value of nighttime pulse oximeter in the treatment of sleep apnea-hypopnea syndrome (SAHS). Methods Forty-four patients with SAHS were monitored for nocturnal dynamic oxygen saturation (SaO2) before and after treatment. The dynamic changes of oxygen saturation index (ODI4), LSaO2 (mean oxygen saturation index), mean Oxygen saturation (MSaO2), time to saturation of less than 90% of total sleep time (SIT90)]. Thirty-five patients underwent home-based continuous positive airway pressure (CPAP) titration at noon and nine at home during the night with home-automated CPAP titration. Results Before and after treatment, the indexes of blood oxygen monitoring (ODI4, LsaO2, MsaO2 and SIT90) were significantly different between groups (all P <0.01). Most patients by 2 to 3 days pressure to be successful. Conclusion The indexes of SIT90, LSaO2, MSaO2 and ODI4 can reflect the therapeutic effect of noninvasive positive pressure airway ventilation. The pulse oximetry monitoring is used to instruct the pressure titration of ventilator. The method is simple and practical, low cost and convenient for home operation.