腭咽环扎术后并发阻塞性睡眠呼吸暂停低通气综合征6例报道  

A serious complication-obstructive sleep apnea hypopnea syndrome after velopharyngeal ring ligation procedure: Report of 6 cases

作　　者：王克涛[1] 魏奉才[1] 赵华强[2] 宋玲[3] 王岩[4] 陈安威[1] 

机构地区：[1]山东大学齐鲁医院口腔颌面外科,山东济南250012 [2]山东大学口腔医学院,山东济南250012 [3]青岛市立医院口腔科,山东青岛266011 [4]山东大学耳鼻喉科学重点实验室,山东济南250012

出　　处：《上海口腔医学》2005年第2期123-126,共4页Shanghai Journal of Stomatology

摘　　要：目的:探讨腭咽环扎术(VRLP)后阻塞性呼吸睡眠暂停低通气综合征(OSAH S)的发生情况及特征。方法:1997～2003年间行腭咽环扎术708例,术后9例出现疑似OSAH S症状。将9例中确诊为OSAH S的6例患者和另外6例术后未发生OSAH S症状的患者行睡眠呼吸检测,进行对照分析,应用χ2检验和t检验进行组间比较。结果:6例12岁以下患儿诊断为OSAH S,且程度严重。12岁以下VRLP后OSAH S发生率为1.8%。与对照组相比,VRLP后OSAH S患者睡眠醒觉频率增加、时间延长,NREM3、4期睡眠和REM期睡眠明显减少。经统计学分析,两组睡眠结构有极显著性差异(P<0.01)。结论:VRLP后OSAH S主要发生在12岁以下儿童,其临床表现和睡眠检测结果与通常的儿童OSAH S有很大差异,呼吸障碍表现为大量的呼吸暂停发作伴有较少量的低通气,出现明显的阶段性低氧血症,睡眠结构也发生紊乱。PURPOSE: To discuss the occurrence and characteristics of obstructive sleep apnea hypopnea syndrome (OSAHS) after velopharyngeal ring ligation procedure (VRLP). METHODS: Seven hundred and eight cleft palate patients underwent velopharyngeal ring ligation procedure from 1997 to 2003. Nine cases were found having some suspicious symptoms of OSAHS after operation and 6 of them were confirmed as OSAHS by polysomnography. Six VRLP patients without OSAHS as controls were examined with polysomnography. Chi-square test and t test were used to determine the statistical differences between the groups. RESULTS: Six cases of 708 patients met the criterion of severe OSAHS and the incidence of OSAHS after VRLP in children below 12 years was 1.8%. Compared with controls, more arousals and longer awakening were found in OSAHS group, the ratio of Ⅲ and Ⅳ phase of NREM and REM in total sleep was significantly decreased (P<0.01). CONCLUSION: OSAHS was likely to occur in VRLP patients below 12 years. Many feature of this kind of OSAHS were different from the ordinary pediatric OSAHS. It showed that OSAHS after VRLP was characterized by more apneas, less partial upper airway obstruction and associated with distinguished staged desaturation.

关 键 词：腭裂 腭咽环扎术 阻塞性睡眠呼吸暂停低通气综合征 并发症 多导睡眠图 

分 类 号：R766.9[医药卫生—耳鼻咽喉科]