الملخص
Objective To explore the factors influencing patient compliance to automatic continuous positive airway pressure (auto-CPAP) treatment in patients with obstructive sleep apnea-hypopnea syndrome (OSAHS). Methods Retrospective analysis was done on 102 patients diagnosed as OSAHS by polysomnography (PSG), who were treated for sleep snoring symptoms between Oct. 2016 and Dec. 2017. All patients received auto-CPAP treatment. The age, gender, body mass index (BMI), Epworth sleepiness scale (ESS) score, nasal obstruction symptom evaluation (NOSE) score and Mallampati score were recorded and analyzed. The patients were divided into compliance group and non-compliance group by the Kribbs standard, and χ2 test and two sample t test were used to analyze the differences of the above indicators between the two groups. Logistic regression model was used to evaluate the risk factors of treatment compliance of OSAHS by auto-CPAP. Results The 102 patients, aged (42.2±10.0) years (ranging from 31 to 83 years), included 89 males and 13 females. Sixty-five (63.7%) patients had good compliance and were assigned to the compliance group, and 37 (36.3%) patients had poor compliance and were assigned to the non-compliance group. The ESS score, NOSE score and Mallampati score were significantly different between the two groups (all P0.05). Logistic regression analysis showed that the ESS score (OR=1.183, 95% CI 1.046-1.338; P= 0.008) and Mallampati score (OR=2.075, 95% CI 1.121-3.839; P=0.020) were independent risk factors of compliance. Conclusion ESS score, NOSE score, and Mallampati score are the influencing factors of treatment compliance to auto- CPAP in the OSAHS patients. ESS score and Mallampati score are the independent risk factors for treatment compliance.
الملخص
Objective To observe the clinical effect of pingyangmycin injection combined with hypercator resection on laryngopharyngeal and laryngeal hemangioma under suspension laryngoscope. Methods Twenty-seven patients with laryngopharyngeal or laryngeal hemangioma were included. After trachea cannula via mouth and general anesthesia, the suspension laryngoscope was used to completely uncover the hemangioma, and 8 mg pingyangmycin (diluted with 6 mL saline injection) was locally injected into the tumor. And then the tumor was completely resected along its root by polypus forceps-like hypercator or was completely coagulated by electric coagulation. The intra-operative and post-operative bleeding were recorded, and the patients were given liquid diets after surgery for two weeks. The fibrolaryngoscope was reviewed to judge the curative effect at 1 month, 3 months, 1 year, 2 years, and 3 years after surgery. Results The pink or prunosus tumor turned into pinkish-white tumor after injection of pingyangmycin. When the root pedicle of the tumor was revealed by forceps holder, the polypus forceps-like hypercator could completely resect the tumor along the base of root, nearly without bleeding in the operation; when the root pedicle was big or could not be revealed, the tumor could be completely coagulated by electric coagulation. After surgery, no patients had dyspnea or wound bleeding. One month later, fibrolaryngoscope showed that the wound was repaired with pink normal mucosa. No recurrence was found in all cases after follow-up for 1 year. After 2 years of follow-up, one case had flaky purple uplift of the pharyngeal wall mucosa, and the tumor was completely resected by the above treatment. No recurrence was found after 3 years of follow-up. Conclusion Hypercator resection after local injection of pingyangmycin under suspension laryngoscope can completely resect the lesions, with less surgery trauma and quick recovery, suggesting that the treatment has affirmative efficacy and is worth popularizing.