【摘要】：第一部分阻塞性睡眠呼吸暫停低通氣綜合征患者與抑郁的關(guān)系研究目的研究阻塞性睡眠呼吸暫停低通氣綜合征(OSAHS)患者與抑郁癥狀的相關(guān)性。方法收集2014年1月-2015年10月來(lái)我院診治的OSAHS患者96例為實(shí)驗(yàn)組,40例健康志愿者作為對(duì)照組,所有受試者均行多導(dǎo)睡眠(PSG)檢測(cè)及Zung抑郁自評(píng)量表(SDS)檢測(cè),實(shí)驗(yàn)組根據(jù)睡眠呼吸紊亂指數(shù)(AHI)及最低血氧飽和度將患者分為輕度組(11例)、中度組(40例)和重度組(45例),比較各組之間抑郁癥狀的患病率。結(jié)果OSAHS組與對(duì)照組的體重指數(shù)、年齡差異無(wú)統(tǒng)計(jì)學(xué)意義,但OSAHS組的AHI數(shù)值、SDS評(píng)分明顯高于對(duì)照組,而最低血氧飽和度(LSa02)則明顯低于對(duì)照組。結(jié)論隨著OSAHS患者病情的加重,抑郁的發(fā)病率逐漸增加。因此,早期診斷及治療OSAHS有利于防止抑郁的發(fā)生。第二部分阻塞性睡眠呼吸暫停低通氣綜合征患者治療前后抑郁癥狀的變化及干預(yù)對(duì)策目的觀察研究阻塞性睡眠呼吸暫停低通氣綜合征(OSAHS)患者在術(shù)前、術(shù)后抑郁的發(fā)生和變化情況。方法收集2014年1月-2015年10月來(lái)我院診治的中重度OSAHS的患者85例,所有患者均行UPPP手術(shù),分別在手術(shù)前、術(shù)后3個(gè)月、術(shù)后半年對(duì)患者進(jìn)行Zung抑郁自評(píng)量表(SDS)自我評(píng)價(jià)。結(jié)果OSAHS患者術(shù)前抑郁癥狀的發(fā)生率為54.1%,術(shù)后三個(gè)月抑郁癥狀的發(fā)生率有所降低,達(dá)到35.3%,術(shù)后六個(gè)月又進(jìn)一步降低,但仍然有13%。SDS評(píng)分于術(shù)前、術(shù)后3月、術(shù)后半年依次遞減,且術(shù)前與術(shù)后3月差異有統(tǒng)計(jì)學(xué)意義,術(shù)后3月與術(shù)后半年差異有統(tǒng)計(jì)學(xué)意義。結(jié)論OSAHS患者手術(shù)后抑郁癥狀明顯改善,手術(shù)是緩解OSAHS患者打鼾等癥狀及抑郁癥狀的一種有效方式。臨床醫(yī)師應(yīng)在術(shù)前對(duì)OSAHS患者存在的抑郁癥狀給予積極關(guān)注,盡量在術(shù)前就采取一定的干預(yù)措施,同時(shí)聯(lián)合患者的家屬及社會(huì)等方面對(duì)患者給予理解、關(guān)心和支持,以期減少術(shù)后抑郁癥狀的發(fā)生,提高手術(shù)療效。
[Abstract]:Part one the relationship between obstructive sleep apnea hypopnea syndrome (OSAS) and depression objective to study the relationship between obstructive sleep apnea hypopnea syndrome (OSAHS) and depressive symptoms. Methods 96 OSAHS patients treated in our hospital from January 2014 to October 2015 were selected as experimental group and 40 healthy volunteers as control group. All subjects were tested with polysomnography (PSG) and Zung depression self-rating scale (SDS). Patients in the experimental group were divided into mild group (n = 11), moderate group (n = 40) and severe group (n = 45) according to sleep respiratory disorder index (AHI) and minimum oxygen saturation. Results there was no significant difference in body mass index and age between the OSAHS group and the control group, but the AHI value and SDS score in the OSAHS group were significantly higher than those in the control group, while the minimum oxygen saturation (LSa02) was significantly lower than that in the control group. Conclusion with the aggravation of OSAHS, the incidence of depression increases gradually. Therefore, early diagnosis and treatment of OSAHS is beneficial to prevent the occurrence of depression. The second part: changes of depressive symptoms and intervention measures in patients with obstructive sleep apnea hypopnea syndrome before and after treatment objective to investigate the changes of depression in patients with obstructive sleep apnea hypopnea syndrome (OSAHS) before and after treatment. Occurrence and change of depression after operation. Methods from January 2014 to October 2015, 85 patients with moderate and severe OSAHS were treated in our hospital. All patients underwent UPPP operation. The patients were evaluated by (SDS) before operation, 3 months after operation and half a year after operation. Results the incidence of depressive symptoms in patients with OSAHS before operation was 54.1. The incidence of depressive symptoms decreased to 35.3in 3 months after operation, and decreased further six months after operation. However, there were still 13%.SDS scores before operation and 3 months after operation. Six months after operation decreased in turn, and there was significant difference between preoperative and postoperative three months, and three months after operation and six months after operation. Conclusion the depressive symptoms of patients with OSAHS were improved obviously, and surgery was an effective way to relieve the symptoms of snoring and depression in patients with OSAHS. The clinicians should pay active attention to the depressive symptoms of patients with OSAHS before operation, take some intervention measures as far as possible before the operation, at the same time, combine the family members of the patients and the society to give understanding, care and support to the patients. In order to reduce the incidence of postoperative depression symptoms and improve the effectiveness of surgery.
【學(xué)位授予單位】：鄭州大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2016
【分類(lèi)號(hào)】：R766;R749.4

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