代谢当量及呼吸睡眠监测联合观察评估中度睡眠呼吸暂停低通气综合征的疗效  

Clinical value of a combined monitoring procedure with treadmillexercise test and polysomnography to evaluate the therapeutic effect of UPPP surgery plus tone base radiofrequency ablation on patients with moderate degree of OSAHS

作　　者：王富森[1] 邹月娥[1] 陈舒华[1] 陈立燕[1] 文风妮[1] 

机构地区：[1]广东省佛山市第二人民医院耳鼻咽喉科,528000

出　　处：《中国中西医结合耳鼻咽喉科杂志》2008年第2期110-112,98,共4页Chinese Journal of Otorhinolaryngology in Integrative Medicine

基　　金：广东省佛山市医学类科技攻关项目(编号200708017)

摘　　要：目的探讨呼吸睡眠监测及代谢当量联合观察法评估中度阻塞性睡眠呼吸暂停低通气综合征患者不同手术方式临床疗效的可行性。方法2003年1月～2006年9月本院手术治疗的65例中度阻塞性睡眠呼吸暂停低通气综合征患者,随机分为UPPP手术联合舌根射频消融术治疗组(手术组,33例)和舌托治疗组(舌托组,32例),分别予以相应治疗。治疗前与治疗后6、12月分别检测观察参数(AHI、最低血氧饱和度、代谢当量),对比分析组间及组内治疗前后不同时期观察参数的变化。结果手术组治疗后1年治愈率12.1%(4/33),显效率42.3%(14/33),有效率33.3%(11/33),无效率13.3%(5/33),且手术治疗前后不同时期观察参数的组内变化差异也具有统计学意义(P<0.05)。术后6、12月代谢当量变化的组间差异具有统计学意义(P<0.05),但AHI和最低血氧饱和度的组间差异无统计学意义(P>0.05)。结论联合观察呼吸睡眠监测指标和代谢当量,可以作为中度阻塞性睡眠呼吸暂停低通气综合征患者疗效评价的组合参数;UPPP联合舌根射频消融术为治疗本病中度患者的有效术式。Objective To investigate the clinical value of a combined monitoring procedure with treadmill exercise tests （METs） and polysomnography （PSG） to evaluate the therapeutic effect of uvulopalatopharyngoplasty （UPPP） surgery plus tone base radiofrequency ablation （TBRFA） on patients with moderate degree of obstructive sleep apnea hypopnea syndrome （OSAHS） based on a study carded out in a group of cases with OSAHS. Methods Included in this study were 65 cases with OSAHS at moderate degree, treated in our Hospital from Jan, 2003 to Sep, 2006, randomly divided into 2 groups, with 33 in surgical therapy group （STG） treated by the combined operation of UPPP plus TBRFA and 32 in tongue deflector group （TDG） treated only by tongue deflector supporting procedure. Measurements were carried out before treatment and 6, 12 months after the therapy among them to determine such indicators as AHI, SaO2 from PSG and data of METs to analyze and compare the differences in these data within group and between different groups. Results The rates of curativeness, significant effectiveness, effectiveness and no effectiveness were 12.1%（4/33）, 42.3%（14/33）, 33.3%（11/33） and 13.3%（5/33） for cases in STG respectively, significantly higher than that in TDG, with very significant improvement in the measured data when compared with before and after the surgery within this group of surgically treated patients （P〈0.05）. There was marked difference seen in the data of METs as measured at the 6th and 12th months respectively after the operation between the two groups （P〈0.05）, while no significant differences were determined in AHI and SaO2 between these two groups following the therapy（P〉0.05）. Conclusions The combined monitoring procedure with METs and PSG can be taken as useful measurable grouping parameters to monitor the therapeutic effects of treating procedures on cases with OSAHS at moderate degree, and the more effective surgical program to treat cases with such a degree of OSAHS

关 键 词：阻塞性睡眠呼吸暂停低通气综合征 手术方式 疗效评价 评估指标 

分 类 号：R766[医药卫生—耳鼻咽喉科]