舌下神经刺激治疗阻塞性睡眠呼吸暂停低通气综合征远期效果的Meta分析

doi:10.3969/j.issn.1004-583X.2022.08.001

摘要/Abstract

摘要：

目的探讨舌下神经刺激疗法治疗阻塞性睡眠呼吸暂停低通气综合征(obstructive sleep apnea-hypopnea syndrome,OSAHS)的远期效果。方法通过系统检索建库至2022年3月中国知网数据库、万方数据库、维普数据库、中国生物医学文献数据库、Pubmed、Embase、Cochrane Library数据中国内外学者发表的舌下神经刺激治疗OSAHS的文献。由2位评价员独立筛选文献、提取资料和采用NOS量表对文献进行质量评价后,采用Stata12.0软件进行Meta分析。结果共纳入12篇队列研究,包括776名患者。术后6个月的睡眠呼吸暂停低通气指数[AHI,均数差(SMD)=-1.47, 95%可信区间(95%CI)-1.68~-1.25,P=0.000]、血氧饱和度下降指数(ODI, SMD=-0.77,CI:-0.95~-0.58,P =0.000)、嗜睡量表评分(ESS, SMD=-1.00,CI:-1.16~-0.84,P=0.000)、睡眠问卷得分(FQSQ, SMD=1.10,CI:0.92~1.28,P =0.000),术后12个月的AHI(SMD=-1.250,CI:-1.39~-1.10,P=0.000)、ODI(SMD=-0.874,CI:-1.114~-0.634,P=0.001)、 ESS(SMD=-1.06, CI:-1.20~-0.91, P=0.000)、 FQSQ(SMD=1.10, CI:0.96~1.22, P =0.000),均较前显著改善。结论舌下神经刺激治疗OSAHS的远期效果是有效的。

关键词: 睡眠呼吸暂停,阻塞性, 舌下神经刺激, Meta分析

Abstract:

Objective To explore the long-term effect of hypoglossal nerve stimulation (HGNS) in the treatment of obstructive sleep apnea hypopnea syndrome (OSAHS). Methods Through the systematic search of China knowledge Network database, Wanfang database, VIP database, Chinese biomedical literature database, Pubmed, Embase, Cochrane Library, the article published by domestic and foreign scholars regarding HGNS, untill to March 2022, were collected. The literatures were screened and extracted by two evaluators independently and the quality of the literatures was evaluated by NOS scale, Meta analysis was carried out by stata12.0 software. Results A total of 12 cohort studies with 776 patients were included. The posttreatment 6-month sleep apnea hypopnea index, (AHI, mean difference [SMD]=-1.47, 95% CI 95% confidence interval [95%CI]-1.68-1.25, P=0.000), oxygen desaturation index (ODI, SMD=-0.77,CI: -0.95--0.58, P=0.000), epworth scale score (ESS, SMD=-1.00, CI: -1.16--0.84, P=0.000), functional qutcomes of sleep questionnaire (FQSQ, SMD=1.10, CI: 0.92~1.28, P=0.000), AHI in 12 months after operation (SMD=-1.250, CI:-1.39--1.10, P=0.000), ODI (SMD=-0.874, CI:-1.114--0.634, P=0.001) and FQSQ (SMD=1.10, CI: 0.96-1.22, P=0.000) were significantly improved than those before treatment. Conclusion Hypoglossal nerve stimulation is effective in the treatment of OSAHS.

Key words: sleep apnea, obstructive, hypoglossal nerve stimulation, Meta analysis

中图分类号:

R563.9

孙莹, 余勤. 舌下神经刺激治疗阻塞性睡眠呼吸暂停低通气综合征远期效果的Meta分析[J]. 临床荟萃, 2022, 37(8): 677-684.

Sun Ying, Yu Qin. Long-term effect of hypoglossal nerve stimulation in the treatment of obstructive sleep apnea hypopnea syndrome: A meta analysis[J]. Clinical Focus, 2022, 37(8): 677-684.

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链接本文: https://huicui.hebmu.edu.cn/CN/10.3969/j.issn.1004-583X.2022.08.001

https://huicui.hebmu.edu.cn/CN/Y2022/V37/I8/677

图/表 13

参考文献 23

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资料来源	研究类型	病例数	结局指标	选择(分)	可比性(分)	结果(分)
Woodson BT(2018)^[5]	前瞻性队列研究	126	AHI、ODI、FQSQ、ESS	3	1	2
Woodson BT(2016)^[6]	前瞻性队列研究	126	AHI、ODI、FQSQ、ESS	3	1	2
Stroll PJ(2014)^[7]	前瞻性队列研究	126	AHI、ODI、FQSQ、ESS	3	1	2
Steffen A(2020)^[8]	前瞻性队列研究	60	AHI、ODI、ESS	3	1	2
Steffen A(2018)^[9]	前瞻性队列研究	60	AHI、ODI、FQSQ、ESS	3	1	2
Kezirian EJ(2014)^[10]	前瞻性队列研究	31	AHI、ODI、FQSQ、ESS	3	1	3
Heiser C (2017)^[11]	前瞻性队列研究	60	AHI、ODI、FQSQ、ESS	3	1	3
Hasselbacher K(2018)^[12]	前瞻性队列研究	56	FQSQ、ESS	3	1	3
Friedman M(2016)^[13]	前瞻性队列研究	56	AHI、ODI、ESS	3	1	2
Eastwood PR(2011)^[14]	前瞻性队列研究	21	AHI、FQSQ、ESS	3	1	2
Malhotra A(2012^[15]	前瞻性队列研究	32	AHI、ODI、FQSQ、ESS	3	1	2
Eastwood PR(2020)^[16]	前瞻性队列研究	22	AHI、ODI、FQSQ、ESS	3	1	3

资料来源	研究类型	病例数	结局指标	选择(分)	可比性(分)	结果(分)
Woodson BT(2018)^[5]	前瞻性队列研究	126	AHI、ODI、FQSQ、ESS	3	1	2
Woodson BT(2016)^[6]	前瞻性队列研究	126	AHI、ODI、FQSQ、ESS	3	1	2
Stroll PJ(2014)^[7]	前瞻性队列研究	126	AHI、ODI、FQSQ、ESS	3	1	2
Steffen A(2020)^[8]	前瞻性队列研究	60	AHI、ODI、ESS	3	1	2
Steffen A(2018)^[9]	前瞻性队列研究	60	AHI、ODI、FQSQ、ESS	3	1	2
Kezirian EJ(2014)^[10]	前瞻性队列研究	31	AHI、ODI、FQSQ、ESS	3	1	3
Heiser C (2017)^[11]	前瞻性队列研究	60	AHI、ODI、FQSQ、ESS	3	1	3
Hasselbacher K(2018)^[12]	前瞻性队列研究	56	FQSQ、ESS	3	1	3
Friedman M(2016)^[13]	前瞻性队列研究	56	AHI、ODI、ESS	3	1	2
Eastwood PR(2011)^[14]	前瞻性队列研究	21	AHI、FQSQ、ESS	3	1	2
Malhotra A(2012^[15]	前瞻性队列研究	32	AHI、ODI、FQSQ、ESS	3	1	2
Eastwood PR(2020)^[16]	前瞻性队列研究	22	AHI、ODI、FQSQ、ESS	3	1	3