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睡眠呼吸暂停综合征患者夜间危险因素及护理对策 |
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申萍 李艳
摘要 睡眠呼吸暂停综合征(sleep apnea syndrome,SAS)是发病率高且有一定潜在危险的疾患。作者对16例SAS住院患者在治疗前、吸氧、气道持续加压(CPAP)呼吸机治疗不同状态下，进行整夜多导睡眠仪(PSG)监测，并进行分析，认为在SAS整夜呼吸紊乱中，零点以后其危险因素大大增加，出现严重低氧血症，血压升高，心律紊乱，尤其是呼吸暂停时间延长、次数增加。而吸氧及侧卧位可显著地改善低氧血症，最低血氧饱和度(SaO2)从62%±19%升高至83%±11%(P<0.01)，CPAP呼吸机治疗能使呼吸调节障碍得到明显的改善，呼吸暂停由44.3±22.6次降至0.28±0.54次(P<0.01)。由此提出护理上应密切观察病情变化，特别是零点以后应加强巡视，除观察呼吸运动外还应警惕脑血管病及心脏疾病的发生，CPAP呼吸机治疗时应加强心理护理及治疗期的护理，对不具备CPAP呼吸机治疗条件者宜采取夜间持续吸氧，在睡眠时督促取侧卧位。此外，对SAS患者进行健康教育是减少危险因素的重要护理措施。
关键词 睡眠呼吸暂停 危险因素 护理
Nocturnal Changes in Sleep-respiratory Variables and Nursing Interventions in Patients with Obstructive Sleep Apnea
Shen Ping,Li Yan
Nanjing General Hospital of PLA,Nanjing 210002
Abstract Objective:To explore the nocturnal changes in sleep-respiratory variables in patients with sleep apnea syndrome (SAS) and nursing interventions in the comprehensive management of SAS.Methods:Sixteen SAS patients were evaluated for 3 separate nights:① night 1 involved a diagnostic polysomnography (PSG) study, and a further evaluation of the PSG recordings at three different time periods.②Oxygen treatment was carried out on night 2;and ③the patients were put on CPAP treatment on night 3.PSG study was repeated on night 2 and 3 respectively.Results:The risk factors increased progressively from time period 1 to time period 2 and time period 3.Oxygen saturation decreased significantly in time period 2 and 3 compared with time period 1.Both sleep position training and oxygen treatment resulted in a significant improvement in hypoxemia,the lowest saturation increased from 62%±19% to 83%±11%(P<0.01).With the treatment of CPAP,a significant improvement in sleep apnea index was also found (from 44.3±22.6 episodes/hour to 0.28±0.54 episodes/hour,P<0.01).Conclusions:The severity of sleep apnea might get worse progressively throughout the night and special attention should be paid t[1] [2] [3] 下一页
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