某教學醫院成立睡眠呼吸檢察室之經驗

The Experience of Establishing a Sleep-related Breathing Disorder Laboratory in a Teaching Hospital

高啟鈞(Chi-Chun Kao) ； 張欣平(Hsin-Pin Chang) ； 黃正憲(Cheng-Hsien Huang) ； 黃弘孟(Hung-Meng Huang) ； 楊文理(Winnie Yang)

《北市醫學雜誌》 12卷3期 (2015/09) Pp. 24-33

https://doi.org/10.6200/TCMJ.2015.12.3.04

摘要

目的：本文報告北市聯醫陽明院區成立睡眠呼吸檢查室的經驗，以及成立前兩年診療患者的概況。方法：本室使用的睡眠多項生理功能檢查儀為Somte full PSG，初創設在院區亞急性病房內，由受過相關訓練的護理人員監看。由神經科醫師判讀報告。結果：自102年1月起兩年內共有383位打鼾及有阻塞型睡眠呼吸中止相關症狀的患者完成檢查，男282、女101位。男性受檢者有中重度睡眠呼吸中止症的比例較高。女性則以單純打鼾和輕度呼吸中止的比例較高，但五十歲後中重度患者明顯增加。過重或肥胖者有睡眠呼吸中止症的比例都較正常體重者高；但正常體重受檢者中19.4%仍有中重度此症。檢查當晚只有近半的受檢者覺得睡的和平常差不多。中重度患者實際治療狀況和醫師建議處置的相符度只有三至四成，沒有後續治療追蹤紀錄的也很多。結論：睡眠多項生理功能檢查，因需專人施作監看，於受檢者睡眠中做必要調整，為高人力成本的檢查。本院區以夜間人力兼看，在相關科室共同努力下，渡過起步時的困難。104年7月開始引進專業之睡眠技師，未來將朝提高檢查品質、增加相關治療的多元性、強化中重度阻塞型睡眠呼吸中止症個案的治療追蹤繼續努力。

關鍵字

睡眠多項生理功能檢查 ； 阻塞型睡眠呼吸中止症 ； 睡眠檢查室

並列摘要

Objectives: This article describes our experience of establishing a new sleep lab and the overview of services during the first two years. Methods: We use Somte full PSG (by Compumedics) with attending polysomnography. The lab was located initially in a subacute ward, attended by the nightshift nurses with prior PSG-related training, and the reports were interpreted by neurologist. Results: From January 2013 to December 2014, 383 cases completed the polysomnography exam in our Lab. Two hundred eighty-two cases were male, and 101 were female. The male cases had higher rate of moderate to severe obstructive sleep apnea (OSA). Most of the female cases had snoring or mild OSA problems, but their prevalence of moderate to severe OSA increased after age of fifty. The prevalence of OSA was higher among overweight or obese cases. However, 19.4% of normal-weight cases had moderate to severe OSA. Only about half of the cases felt a regular sleep during the test night. Only approximately one third of the actual treatments for the moderate to severe OSA cases were in concordant with the treatments recommended by the doctors. Also, many patients had no records on subsequent treatments. Conclusion: We overcame the demand on manpower during the start-up of a new sleep lab in a regional hospital by sideline working and team efforts. On July 2015, we started to employ a sleep technician to conduct the examinations. We will keep on improving the test quality, develop more treatment options, and strengthen the treatments and follow-up of our moderate to severe OSA patients.

並列關鍵字

Polysomnography ； obstructive sleep apnea ； sleep Lab