【摘要】 目的:评价阻塞性睡眠呼吸暂停低通气综合征(OSAHS)合并基底节区脑卒中患者应用经鼻持续呼吸道正压通气(nCPAP)和(或)认知康复和(或)基础康复3种不同治疗措施对其睡眠、运动、认知、心理和日常生活能力的疗效。方法:共96例OSAHS合并基底节区脑卒中患者入选本研究,其中27例患者为nCPAP+认知康复组,采用nCPAP+认知康复治疗12周;33例患者为认知康复组,仅采用认知康复治疗;36例患者为对照组。3组患者在治疗前、后均进行多导睡眠图(PSG)监测,进行运动能力及认知、心理、日常生活能力评分,并对相关结果进行对比分析。结果:应用3种不同措施治疗OSAHS合并基底节区脑卒中患者12周后,nCPAP+认知康复组在PSG参数[包括呼吸暂停低通气指数(AHI)、最低氧饱和度、运动功能(FMA)评分、汉密尔顿焦虑量表(HAMA)、汉密尔顿抑郁量表(HRSD)评分较认知康复组及对照组的各项指标明显改善(均P<0.01)。nCPAP+认知康复组及认知康复组在简易精神状态检查(MMSE)量表总评分及地点定向、复述、计算、记忆力、语言项目方面较对照组明显改善(均P<0.01)。nCPAP+认知康复组Barthel指数(BI)评分较对照组明显改善(P=0.027)。结论:OSAHS合并基底节区脑卒中患者经nCPAP+认知康复治疗12周后,其睡眠、认知、运动功能、心理状态均明显改善。更多还原

【Abstract】 Objective To evaluate the therapeutic efficacy of three different strategieson patients of obstructive sleep apnea hypopnea syndrome combined with basal ganglia stroke.Methods Ninety-six patients of obstructive sleep apnea hypopnea syndrome(OSAHS) combined with basal ganglia stroke were divided into three groups.Twenty seven patients were given nasal continuous positive airway pressure(nCPAP) plus cognitive rehabilitation for 12 weeks,33 patients were given cognitive rehabilitation,and 36 patients were served as controls.Polysomnography(PSG),Fugl-Meyer assessment scale(FMA),mini-mental status examination(MMSE),Barthel index(BI),Hamilton anxiety scale(HAMA),Hamilton depression scale(HRSD) were evaluated and compared at pre-and post-12-week program.Results After 12-weeks of treatment,the parameters of PSG such as apnea hypopnea index(AHI),minimum oxygen saturation,and scales of FMA,HAMA,HRSD improved significantly in nCPAP plus cognitive rehabilitation group when compared with the cognitive rehabilitation group and control group(P <0.01).The scales of MMSE in nCPAP plus cognitive rehabilitation group and cognitive rehabilitation group improved significantly(P <0.01) when compared with the control group,such as place orientation,retell,calculation,memory and language.The scales of BI improved significantly(P=0.027) in treatment group when compared with the control group.Conclusions For patients of OSAHS combined with basal ganglia stroke,12-weeks of nCPAP plus cognitive rehabilitation improved significantly the sleep,cognition,motor function and psychology.更多还原