A Clinical Study Of Different Intervention Methods For The Treatment Of Obese Obstructive Sleep Apnea-hypopnea Syndrome

Part 1Clinical study on the efficacy of continuous positive airway pressure(CPAP)for obese obstructive sleep apnea-hypopnea syndromeObjective:To explore the efficacy of continuous positive airway pressure(CPAP)for obstructive sleep apnea-hypopnea syndrome(OSAHS)in obese people.Methods:The clinical and follow-up data of 45 obese patients with OSAHS who underwent CPAP in the department of respiratory and ear-nose-throat of Zibo Central Hospital from January 2016 to December 2018 were analyzed retrospectively.The effect of CPAP on patients' sleep disorder,hypoventilation and hypoxemia were studied.Results:Total 45 patients completed CPAP treatment.After 3 months of CPAP treatment and follow-up,the sleep disorder symptoms of the patients were significantly improved:ESS scores and PSQI scores were significantly reduced(P<0.05).The apnea hypopnea index(AHI)was reduced from 24.08±5.17 times/h to 7.82±2.95 times/h,and lowest arterial oxygen saturation(LSaO2)at night was increased from 82.20±4.92%to 91.04±1.78%,conscious oxygen pressure increased from 82.06±4.63mmHg to 89.96±3.31mmHg,which was significantly improved compared with that before treatment(P<0.05).Conclusion:CPAP can effectively improve the sleep disorder and chronic hypoxia in patients with OSAHS,and it is a reliable treatment for OSAHS.Part 2A mid-term clinical study of the efficacy of laparoscopic sleeve gastrectomy for obese obstructive sleep apnea-hypopnea syndromeObjective:This study was designed to explore the efficacy of laparoscopic sleeve gastrectomy(LSG)for obstructive sleep apnea-hypopnea syndrome(OSAHS)in obese people and to identify the related factors affecting its efficacy.Methods:The clinical and follow-up data of 37 obese patients with OSAHS who underwent LSG in the Laparoscopic Surgery Department of Zibo Central Hospital from January 2017 to July 2018 were analyzed retrospectively.The effect of this operation on patients'weight and OSAHS was studied,and the factors affecting weight and OSAHS were examined through univariate and multivariate logistic regression analysis.Results:Over 12 months of regular postoperative follow-up with the 37 patients,their body mass index(BMI)decreased,and the percentage of excess weight loss(EWL%)reached 73.20%;additionally,the rate of successful OSAHS treatment reached 91.89%,and the apnea-hypopnea index(AHI)and lowest arterial oxygen saturation(LSaO2)increased significantly.Univariate logistic regression analysis showed that gender,weight,neck girth,EWL%and smoking affected the efficacy of LSG against OSAHS(p<0.05);EWL%,smoking and neck girth were independent factors that helped determine the efficacy of LSG against morbid obesity(p<0.05).Conclusion:LSG can effectively help obese patients lose excess weight and shows medium-term efficacy against OSAHS in obese people.Smoking,EWL%and neck girth appeared to be the factors determining the efficacy of LSG.