| ObjectiveResearch show that about90%of the obstructive sleep apnea hypopneasyndrome (OSAHS) patients without clinical diagnosis in America,the complications and mortality of untreated patients increased significantly. Theclinical diagnosis rate of OSAHS patients may be lower in China, for treatment statusof diagnosed patients also lacking understanding, We intend to investigate thetherapeutic status of OSAHS patients diagnosed by polysomnography (PSG) in ourhospital.MethodsWe used telephone interviews to investigate treatment condition of3080OSAHSor simple snoring patients who were diagnosed by PSG in the first affiliated hospitalof guangzhou medical university during the period from January2001to June2011,after the collected data and PSG monitoring report to be gathered, to be performedcomparison of related indicators and statistical analysis.Results(1) Successful visit1270patients, including1126OSAHS patients,114simplesnoring patients, the average return visit success rate was41.23%, the main reason oflost to follow-up was contact number changed, accounted for82.65%.(2)627OSAHS patients (55.68%) accepted treatment, including pure CPAP treatment281people (24.95%), pure surgery treatment125people (11.10%), pure weight loss84people (7.46%), and comprehensive treatment78people (6.93%), other59people(5.24%).(3) Untreated OSAHS patients had499people (44.32%), untreated mainreasons were:253people (50.70%) thought the illness was not serious and didn’t needto treat,84people (16.84%) feared of surgery, or felt trouble to wear respirator or oralappliance,75people (15.03%) had not time to treat because of busy work,58people (11.62%) worried about treatment effect,29people (5.81%) thought treatment costwas too expensive to afford it.(4) the sleep quality total improvement rate andsignificant improvement rate of pure CPAP treatment patients were87.54%,48.75%respectively, pure surgery were77.60%,34.40%, pure weight loss were77.38%,19.05%, comprehensive treatment were89.74%,50.00%; the sleep quality totalimprovement rate and significant improvement rate of pure CPAP and comprehensivetreatment patients were not statistical difference (P>0.05), and both were higher thanthe rest of treatment methods (P <0.05); the pure surgery patients compared with pureweight loss patients, the sleep quality total improvement rate was not statisticaldifference (P>0.05), the significant improvement rate was significantly higher thanthat of pure weight loss patients (P <0.01), but there were29patients (29.90%), ofwhich postoperatively sleep quality improved patients relapsed after a period of time.(5) used CPAP treatment patients had281patients,116patients (41.28%) eventuallycompletely gave up treatment,47patients (40.52%) of which felt trouble to adhere totreat,27patients (5.25%) felt inefficacious,19patients (16.38%) wearing respiratorfelt intolerance or uncomfortable,16patients（13.79%）thought no longer needto treat because of symptom significantly improvement,7patients (6.03%)abandoning treatment because of other reasons;(6) In125patients with puresurgical treatment,86(68.80%) patients were treated by UPPP or modified UPPP,17patients16.38%) by nasal cavity expansion technique,14patients (11.20%) bytonsillectomy,8patients (6.40%) by other surgical methods.(7) The hypertensionprevalence rates of simple snoring, mild, moderate, severe and total OSAHS patientswere13.19%,23.47%,29.33%,37.30%,33.21%, respectively. with the increase ofOSAHS severity, hypertension prevalence rates were also rising (X2=40.40, P <0.01);the hypertension prevalence of total OSAHS patients was significantly higher thanthat of simple snoring patients (P <0.01).(8) The accepting treatment rates ofsimple snoring, mild, moderate, severe and total OSAHS patients were25.00%,35.68%,44.71%,64.96%,55.68%, respectively. with the increase of the severity ofOSAHS, the accepting treatment rates of OSAHS patients were also rising(X2=116.70, P <0.01); The accepting treatment rates of total OSAHS patients wassignificantly higher than that of simple snoring patients (P <0.01).(9) Theaccepting treatment rates of simple snoring, mild, moderate, severe and total OSAHSpatients having hypertension group were26.35%,38.00%,55.74%,38.00%,65.51%, respectively, without hypertension group accepting treatment rates were24.80%,34.97%,40.14%,60.18%,51.60%, respectively. Comparing simple snoring and mildOSAHS patients with hypertension group and without hypertension group, theaccepting treatment rates had no statistical difference (P>0.05); the moderate, thesevere and total OSAHS patients with hypertension group accepting treatment ratewere significantly higher than that without hypertension group (P <0.05).Conclusions1.44.32%patients did not take any treatment measures, the lack of awarenessof the disease perniciousness was the main factor influencing the treatment, respiratortrouble, afraid of surgery, worrying treatment effect, expensive treatment cost werealso the important influencing factors.2. In treated patients, nearly half of CPAP therapy, may be associated with oursleep monitoring room belonging respiratory medicine, but gave up about CPAPtherapy. In treating patients, nearly half adopting CPAP therapy, which may beassociated with our sleep monitoring room belonging to respiration medicine, butabout40%patients treated with CPAP gave up CPAP treatment.3. With the increase of OSAHS severity and prevalence rate of hypertension,patients accepting treatment rate were also rising.4. By observing the treatment status of patients diagnosed with OSAHS througha long, large sample data, this research shows that it couldn’t be optimistic about thetreatment of patients with OSAHS in China and the efforts was needed to strengthenpatients’ awareness of the disease, improving treatment effect, etc... |
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