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1、广西医科大学学报2001Dec;18(6)·780.JOURNALOFGUANGXIMEDICALUNIVERSITY阻塞性睡眠呼吸暂停与胃食管反流的关系‘张法灿黄陆颖梁列新蔡联英蔡保芳刘建红(广西壮族自治区人民医院南宁530021)摘要目的:探讨阻墓性睡眠呼吸暂停(USA〕与胃食管反流(GER)的关系及经异持续气道正压通气的疗效。方法22例典型OSAS症状患者同步进行多导睡眠图(PSG)食管pH监测,对并有GER患者行连续10晚经鼻持续气道正压通气(nC-PAP)治疗。后复查PSG和食管pHa结果:22例患者
2、均为USA,有11例为OSAS并GER,其中7例进行10晚nCPAP治疗后,呼吸暂停低通气指数(AHI)从36.54士21.35减少到10.03士4.85(尸<。.05);DeMeeste:评分从55.56士29.59减少到22.30士23.23(P<0.05);卧位pH<4时间百分比从18-71+17-08减少到4.37t6.62(P<0.05);酸反流次数也明显减少(P<0.05)e结论GER与USA相关,USA可能是GER的原因之一,对OSA并GER者进行nCPAP治疗有良效.关扭词阻塞性睡眠呼吸暂停;胃
3、食管反流;经鼻持续气道正压通气中国圈书资料分类法分类号R56,R57THERELATIONSHIPBETWEENOBSTRUCTIVESLEEPAPNEAANDGASTRO-ESOPHAGEALREFLUXZhangFacan,HuangLuying,LiangLiexin,etal,(DepartmentofInternalMedicine,ThePeople'sHospitalofGuangxiZhuangAutonomousRegion,Nanning,530021China)AbstractObject
4、ive:Tostudytherelationshipbetweengastroesophagealreflux(GER)andobstructivesleepapnea(OSA)andthetherapeuticuseofnasalcontinuouspositiveairwaypressure(nCPAP).Methods:24-houresophagealpHmonitoringandpolysomnography(PSG)wereperformedsimultaneouslyin15caseswithty
5、picalsymptomsofobstructivesleepapneasyndrom(OSAS).ThepatientswithGERweretreatedwithnCPAPfortennights,andthenthesametestsabovewererepeated.Results:10ofthe15patientswithOSAshowedGER.7ofthe10patientstookthenCPAP,andAHIwasdecreasedfrom36.54士21.35beforenCPAPto10.
6、03士4.85afternCPAP(P<0.05),DeMeesterscoringfrom55.56士29.59to22.30士23.23(P<0.05),thepercentageofsupineacideexposuretimefrom18.71士17.0to4.37士6.62(P<0.05),totaltimesof,acidrefluxwerereducedsignificantly.Conclusion:OurresultssuggestthatOSASmaypredisposetoGER.nCPA
7、PeffectivelyreducedGERinthosewithgastroesophagealrefluxKeywordsobstructivesleepapnea;grastroesophagealreflux;nasalcontinuousaiwaypressure.二广西区科技厅资助课题(桂科攻9920024)收稿日期:2001一02一10果。经过观察6个月至3年.除高度近视眼有个别患者视力Plikaris1,PapatsanakiM,StabiE,etal.Laserinsituker下降1至3行外
8、。其他患者视力都比较稳定,没有下降。实atornileusis.LasersSurgMed,1990.10:436.践证明LASIK手术安全性高、稳定性好、并发症少,是目前柳林主编,现代眼科屈光手术学.北京:人民军医出较好的角膜屈光手术版社.1995.231,238.伊藤光登志.新屈折矫正手术.临床眼科,1997.5:参考文献(11):323.廉井才,周德佐,叶纹,等.准分子激光角膜原