悬雍垂腭咽成形术联合鼻部手术治疗OSAHS疗效分析  

Effect of UPPP combined with nasal surgery for patients with obstructive sleep apnea-hypopnea syndrome

作　　者：雷大鹏[1] 潘新良[1] 李学忠[1] 许风雷[1] 刘大昱[1] 张立强[1] 

机构地区：[1]山东大学齐鲁医院耳鼻咽喉科,山东济南250012

出　　处：《山东大学学报（医学版）》2007年第9期958-960,共3页Journal of Shandong University:Health Sciences

基　　金：山东省自然科学基金资助课题(Y2006C54)

摘　　要：目的：探讨悬雍垂腭咽成形术（uvulopalatopharyngoplasty,UPPP）联合鼻部手术治疗阻塞性睡眠呼吸暂停低通气综合征（obstructive sleep apnea-hypopnea syndrome,OSAHS）的临床疗效。方法：所有患者术前均行多导睡眠呼吸监测（polysomonography,PSG）确诊,在行UPPP手术同期行鼻中隔偏曲粘膜下切除术18例,双侧下鼻甲粘膜下部分切除术20例,腺样体切除术2例。其中5例重度患者术前先在局麻下行气管切开,然后在全麻下行UPPP和鼻部手术,其中2例患者选择了气管切开后6-7 d再行UPPP和鼻部手术。术后随访1-2年。结果：患者均有不同程度的症状减轻,其中症状基本消失者5例,明显减轻者14例,症状缓解者6例。无术后并发症发生,术后6-13 d（平均8.3 d）拔除了气管套管。结论：UPPP联合鼻中隔偏曲矫正、下鼻甲部分切除术治疗OSAHS可取得良好的手术疗效,对于重度OSAHS患者,行前置性气管切开术,能够有效预防手术并发症的发生。Objective： To evaluate the clinical efficiency of uvulopalatopharyngoplasty （UPPP） combined sub-mucous resection of the nasal septum or inferior turbinate for patients with obstructive sleep apnea-hypopnea syndrome（OSAHS）. Methods： All the patients were diagnosed by polysomonography and treated by UPPP. At the same time, sub-mucous resection of the nasal septum was performed on 18 patients, submucous resection of the bilateral turbinate on 20 patients, and adenoidectomy on 2 patients. All of the nasal surgeries were performed by an endoscope. Prophylactic tracheotomy was performed on 5 severe cases. In another 2 cases tracheotomy were performed about 6-7 days before. All the patients were followed up for 1 to 2 years. Results： Symptoms of all the patients were alleviated to some degree ： disappeared in 5 patients, reduced in 14 patients, alleviated in 6 patients. No complications occurred. Patients on whom tracheotomies were performed were decannulated in 6-13 days postoperatively. Conclusion： For OSAHS patients, UPPP combined with sub-mucous resection of nasal septum or inferior turbinate could give a better result. For severe OSAHS patients, prophylactic tracheotomy could avoid surgical complications.

关 键 词：睡眠呼吸暂停 阻塞性 外科手术 悬雍垂腭咽成形术 鼻中隔偏曲矫正术 下鼻甲部分切除术 

分 类 号：R762[医药卫生—耳鼻咽喉科]