| Objectives To treat obstructive sleep apnea hypopnea syndrome by continuous positive airway pressure(CPAP),bi-level positive pressure ventilation(Bi PAP),and average volume-assured pressure support(AVAPS).The differences in the effects of the three ventilation methods were compared to provide a basis for the optimal noninvasive ventilation for patients with different characteristics of OSAHS.Methods A total of 95 patients with OSAHS diagnosed in our hospital from November2016 to November 2018 were randomly divided into three groups.The Curative ventilator CPAP mode(CPAP group),Bi PAP mode(Bi PAP group)and average capacity guarantee were used.Pressure support mode(AVAPS group)was given for non-invasive ventilation therapy.Baseline data before non-invasive ventilation intervention were recorded.AHI,arousal index,mean SPO2,minimum SPO2,ODI,mean arterial pressure,immediate PCO2 and ESS score,and tidal volume equivalents were measured 24 hours and 1 week after treatment.The rank sum test was used to indicate that the analysis did not obey the normal distribution;the comparison between the groups of the count data was compared using the chi-square test before and after the intervention using the paired ton test or the paired rank sum test with P < 0.05 difference.It is statistically significant.After 1 week of treatment,the clinical symptoms,nighttime sleep quality,daytime activities,and AHI reduction were recorded for the three groups,and the clinical efficacy was evaluated and compared.Results 1 patients with three modes of ventilation intervention for 24 h and one week,can significantly reduce patients with AHI,arousal index,ODI,MAP mean arterial pressure and ESS score,the difference was statistically significant(P <0.05);At the same time,the average SPO2 level,the lowest SPO2 level and the tidal volume(P<0.05)were observed.The CPAP mode treatment significantly reduced PCO2 after 24 hours and 1week(P<0.05),but after 1 week of treatment and treatment The PCO2 level decreased significantly after 24 hours(P>0.05).In the experience of AVAPS mode and Bi PAP mode,the patient's PCO2 level was significantly lower(P<0.05).After 1 week of treatment,the PCO2 level decreased significantly after treatment for 24 hours(PO2>0.05).P<0.05).2 After 24 hours of treatment,there was no significant difference between the three groups and multiple comparisons between the three groups(P > 0.05);comparison AHI,arousal index,average SPO2,minimum SPO2,ODI,PCO2 and tidal volume three The difference between the groups was statistically significant(P<0.05)vs.24 h AHI,AVAPS was lower than CPAP(P<0.05);compared with 24-hour arousal index,AVAPS and Bi PAP were lower than CPAP(P<0.05);compared with 24 h ODI,AVAPS group was lower than CPAP group(P<0.05);compared with 24-hour minimum SPO2,AVAPS group was higher than CPAP group(P<0.05);compared with 24-hour average SPO2,AVAPS group and Bi PAP The group was higher than the CPAP group(P<0.05).Compared with the 24 h PCO2,the PCO2 in the BIPAP group and the AVAPS group was significantly lower than that in the CPAP group(P<0.05),and the PCO2 in the AVAPS group was significantly lower than that in the Bi PAP group(P<0.05).Compared with the24-hour tidal volume,the tidal volume of the Bi PAP group and the AVAPS group was significantly higher than that of the CPAP group(P<0.05),while the tidal volume of the AVAPS group was significantly higher than that of the Bi PAP group(P<0.05).3 After 1week of treatment,the comparison between the three groups and multiple comparisons compared with MAP,ODI three groups were not statistically significant(P>0.05);compared AHI,arousal index,average SPO2,minimum SPO2,PCO2 and tidal volume levels The difference in ESS scores was statistically significant(P<0.05).The three groups of data were compared by two pairs.The AHI values were compared with the APAPS group(P<0.05).The comparison of the arousal index,Bi PAP group and AVAPS group.It was significantly lower than the CPAP group(P<0.05),and the AVAPS group was significantly lower than the Bi PAP group(P<0.05).Compared with the mean SPO2,the Bi PAP group and the AVAPS group were significantly higher than the CPAP group(P<0.05).Compared with the lowest SPO2,the AVAPS group was significantly higher than the CPAP group(P<0.05);compared with PCO2,Bi PAP group and AVAPS group were significantly lower than CPAP group(P<0.05);contrast tidal volume,Bi PAP group and AVAPS group tidal volume It was significantly higher than the CPAP group(P<0.05),while the tidal volume of the AVAPS group was significantly higher than that of the Bi PAP group(P<0.05).Compared with the ESS score,the Bi PAP group and the AVAPS group were significantly lower than the CPAP group(P<0.05).4 The clinical efficacy of the three groups were significantly different(P<0.05).The clinical effective rate of AVAPS group(100%,markedly effective in 28 cases,effective in 2 cases,ineffective in 0 case)was higher than that in Bi PAP group(93.94%,markedly effective in 24 cases,effective in 7 cases,ineffective 2)Example)was higher than CPAP group(87.5%,19 cases were markedly effective,9 cases were effective,4 cases were ineffective)Conclusions : 1 Three non-invasive ventilation treatment of OSAHS patients are effective,can improve sleep quality and quality of life,improve hypoxemia and hypercapnia,AVAPS best.2 After three weeks of treatment in the three groups of patients,the indicators were mostly better after 24 hours of treatment.The OSAHS patients adhered to the long-term application of non-invasive ventilation treatment.3 The application of non-invasive ventilation,AVAPS mode treatment is higher than the CPAP mode tidal volume level,can further reduce the PCO2 partial pressure,more suitable for patients with hypercapnia with OSAHS.4 AVAPS mode relative to Bi PAP mode can reduce PCO2 in a short time,suitable for patients with acute and severe OSAHS with hypercapnia.5 AVAPS mode and non-invasive ventilation mode is more obvious than CPAP mode to improve hypoxia.For patients with OSAHS who have poor CPAP with hypoxemia,AVAPS and non-invasive ventilation mode can be used?Figure3;Table12;Reference 123... |
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