Multidisciplinary Interaction Model In The Treatment Of Severe Obstructive Sleep Apnea-hypopnea Syndrome

Objective:Obstructive sleep apnea syndrome(OSAHS)is a complex etiology,which involves upper airway stenosis,pharyngeal nerve sensory function or pharyngeal function decline,obesity,central ventilation control disorder and endocrine disorders.At present,OSAHS is still one of the difficult problems in the treatment of Otolaryngology and Department of respiration,especially the severe OSAHS.This paper focuses on the treatment of severe OSAHS with multidisciplinary interaction and the control of related complications.Methods:A retrospective cohort study was carried out in Hunan People's Hospital.486 cases of OSAHS patients with complete data were collected from Hunan People's Hospital.The visiting time was between January 1,2010 and December 31,2016.486 cases were divided into the control group and the experimental group because of the difference in the treatment pattern,which was used for comparative study.The control group used the old treatment mode,the treatment time between January 1,2010and December 31,2013,a total of 209 cases,including 29 patients with hypertension,17 patients with diabetes,4 patients with diabetes and hypertension.The experimental group used a new multidisciplinary interaction mode to treat OSAHS patients,the treatment time was from January 1,2014 to December 31,2016,a total of 277 cases,including 39 patients with hypertension,23patients with diabetes,6 patients with diabetes and hypertension.In the control study,the postoperative bleeding rate,recatheterization rate and tracheotomy rate were carefully compared between the two groups.Results:Six months after operation,the OSAHS patients were evaluated by polysomnography(PSG)or Epworth sleepiness scale(Epworth Sleepiness Scale).After monitoring and evaluation,there were no significant differences in preoperative respiratory disturbance index(AHI),minimum oxygen saturation LS02%and Epworth scores between the control group and the experimental group(P>0.05).After treatment,there were statistical differences between the control group and the experimental group on AHI,LSO2%and Epworth scores(P<0.05).In addition,the control group of patients with postoperative bleeding in 21 cases,18 cases underwent tracheal intubation,3 cases of intraoperative bleeding.again when intubation is not smooth,tracheotomy,1 cases in the first operation performed an emergency tracheotomy;while the experimental group with statistical results slightly better,postoperative bleeding in patients with 15 cases,patients with tracheal intubation downward hemostasis in only 1 cases,no patients with tracheotomy.Conclusion:Using multidisciplinary interaction mode to treat severe OSAHS can effectively reduce postoperative bleeding and suffocation risk and improve subjective and objective efficacy after operationi,which reflect the new thought of the patient centered.