To Explore The Feasibility And Clinical Significance Of Using CPAP During 1 Weeks Before Surgery And One Week After Operation Of Moderate And Severe OSAHS Patients Undergoing H-UPPP Surgery

Background: OSAHS is a common disease and frequently occurring disease in ENT department,It affects multiple systems in bodies,Causes refractory hypertension,type 2 diabetes mellitus,coronary heart disease and other diseases.OSAHS therapy includes behavioral intervention,internal medicine therapy and surgical treatment.Postoperative hypoxemia hypercapnia respiratory obstruction and postoperative bleeding were common complications of surgery.To reduce complications,most of them were treated by CPAP from 1 to February before operation,However,preoperative 1 ~ February CPAP therapy patients are difficult to adhere to very well,thus not enough to reduce complications.CPAP is used during perioperative periods,which is common understanding,But when start to use and how long whether it is suitable for China's situation there is no unified understanding.Objective: To explore the feasibility and clinical significance of using CPAP during 1 weeks before surgery and one week after H-UPPP operation.Method: Totally60 cases of moderate and severe OSAHS patients who underwent H-UPPP surgical treatment in our hospital from January 2014 to August 2016 were enrolled and randomly divided into Perioperative CPAP Treatment group(A group)and Non-therapeutic group(B group),30 cases in each group.Patients in B group were given routine intervention but without CPAP treatment in the perioperative period,while the A group were given CPAP treatment on the basis of B group.Comparison of PSG changes after CPAP therapy in preoperative group of patients with preoperative therapy,PSG changes before surgery and one week after surgery were performed in both groups,Incidence rates of Perioperative hypoxemia hypercapnia respiratory obstruction postoperative bleeding were observed in both groups,Comparison of postoperative effectiveness of two groups(curative effect:cure?obvious effect?effective,ineffective,apparent rate = cure rate + obvious efficiency)and degree of sleepiness were observed after 6 months postoperatively.Results: After 1 weeks CPAP therapy,A group had significantly improved after treatment without treatment(P<0.01);There were no significant differences of PSG monitoring indicators between the two groups before treatment(P>0.05),all the indicators were improved after treatment,PSG was monitored one week postoperatively.the lowest Sa O2,rapid eye movement rate and stage 3 and 4 sleep rate in A group after treatment was higher than that in the B group,the apnea hyponea index and CT90 were lower than that in the B group,the differences were statistically significant(P<0.05);The perioperative complication rate in the observation group was 6.67%,which was significantly lower than 26.67% in the control group(P<0.05).6 months after operation,Follow-up PSG monitoring,AHI,CT 90%,LSa O2%,ESS index were significantly superior to those in group B-1 group.The therapeutic rate of treatment was 76.67% in group A,which was higher than 50.00% in the group B,the difference was statistically significant(P<0.05).Conclusion: During 1 weeks before surgery and one week after operation of moderate and severe OSAHS patients undergoing H-UPPP surgery,the CPAP therapy can effectively alleviate the condition of patients,improve the sleep structure,Reduce hypoxemia in sleep,Reducing chronic hypoxia in the human body,Enhance the defense ability of human organs to external trauma,Improve therapeutic effect and reduce the risk of complications,so the safety of surgery could be enhanced,it is worth promoting.