中国老年保健医学2024,Vol.22Issue(4) :37-42,48.DOI:10.3969/j.issn.1672-2671.2024.04.008

经静脉膈神经刺激治疗中枢性睡眠呼吸暂停综合征的单臂Meta分析

A Single arm Meta-analysis of transphrenic nerve stimulation for central sleep apnea syndrome

朱鹏力 王剑 严志华 梁丹 杜叶佳 阮丹琦
中国老年保健医学2024,Vol.22Issue(4) :37-42,48.DOI:10.3969/j.issn.1672-2671.2024.04.008

经静脉膈神经刺激治疗中枢性睡眠呼吸暂停综合征的单臂Meta分析

A Single arm Meta-analysis of transphrenic nerve stimulation for central sleep apnea syndrome

朱鹏力 1王剑 1严志华 1梁丹 1杜叶佳 1阮丹琦1
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作者信息

  • 1. 绍兴上虞人民医院肿瘤内科一放疗科 312300
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摘要

目的 进一步明确经静脉膈神经刺激治疗中枢性睡眠呼吸暂停综合征的有效性及安全性.方法 通过计算机检索Cochrane Library、Web of Science、Embase、PubMed、中国知网、万方数据库等,根据纳入标准与排除标准筛选文献,采用RevMan5.4软件进行Meta分析.结果 本研究共纳入文献9篇,包括365例中枢性睡眠呼吸暂停综合征(CSA)患者,发现经静脉膈神经刺激在改善中枢性睡眠呼吸暂停综合征(TPNS)患者低通气指数(AHI)(MD=26.2,95%CI 24.21~28.2,P<0.001)、中枢性呼吸暂停低通气指数(CHI)(MD=23.67,95%CI 20.30~27.05,P<0.001)、氧减指数(ODI)(MD=22.99,95%CI 20.99~25.00,P<0.001)、觉醒指数(MD=16.61,95%CI 13.43~19.8,P<0.001)、Epworth 嗜睡量表评分(ESS)(MD=-50.34,95%CI-60.91~-39.77,P<0.001)等方面均具有明显统计学意义.纳入的研究中1例患者出现治疗相关的心律失常、9例患者出现装置植入失败/装置相关性感染,其余未追踪到明显的TPNS相关性不良事件.结论 经静脉膈神经刺激对于中枢性睡眠呼吸暂停综合征患者的睡眠参数有改善价值,且其安全性使得肯定.

Abstract

Objective To evaluate the efficacy and safety of transphrenic nerve stimulation in the treatment of central sleep ap-nea syndrome.Methods Cochrane Library,Web of Science,Embase,PubMed,CNKI,Wanfang Data and other databases were searched by computer.Literatures were screened according to inclusion and exclusion criteria,and Meta-analysis was performed u-sing RevMan 5.4 software.Results A total of 9 literatures meeting the criteria were included,including 365 CSA patients.TPNS was found to improve AHI(MD=26.2,95%CI 24.21~28.2,P<0.001),CHI(MD=23.67,95%CI 20.30~27.05,P<0.001),ODI(MD=22.99,95%CI 20.99~25.00,P<0.001),arousal index(MD=16.61,95%CI 13.43~19.8,P<0.001),Epworth sleepiness score(MD=-50.34,95%CI-60.91~-39.77,P<0.001)were statistically significant.Among the included stud-ies,1 patient had treatment-related arrhythmia,9 patients had device implantation failure/device-associated infection,and no signifi-cant TPNS related adverse events were traced.Conclusion Transcranial phrenic nerve stimulation can improve the sleep parameters of patients with central sleep apnea syndrome,and its safety is certain.

关键词

经静脉膈神经刺激/中枢性睡眠呼吸暂停综合征/有效性/安全性

Key words

transvenous phrenic nerve stimulation/central sleep apnea syndrome/availability/safety

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出版年

2024
中国老年保健医学
中国老年保健医学研究会

中国老年保健医学

影响因子:0.637
ISSN:1672-4860
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