双极射频等离子舌根缩容术在阻塞性睡眠呼吸暂停低通气综合征中的应用  

Application of bipolar radiofrequency plasme surgery for volumetric reduction of tongue base in treating OSAHS

作　　者：姜小兵[1] 纪维纲[1] 叶星[1] 

机构地区：[1]北京军区总医院耳鼻咽喉头颈外科,北京100700

出　　处：《中国现代医学杂志》2009年第16期2494-2495,2499,共3页China Journal of Modern Medicine

摘　　要：目的研究双极射频等离子手术系统在治疗鼾症和阻塞性睡眠呼吸暂停低通气综合征(OSAHS)中的应用及疗效。方法65例患者中57例OSAHS及8例鼾症,均已行前期治疗去除舌后隙以外的阻塞因素,如:下甲部分切除术、鼻中隔矫正术、鼻息肉切除术等。以双极射频等离子手术系统行舌根缩容术。分析术前术后患者的症状及多导睡眠监测(PSG)、纤维内镜结果。结果每例患者舌根部2、3点行黏膜下低温消融,术后患者症状明显减轻。平均呼吸紊乱指数(RDI)由术前(39.4±9.7)降至(10.6±7.4),平均最低血氧饱和度由术前(68.5%±8.3%)升至(87.6%±6.2%),纤维内镜显示舌根体积缩小、舌后气道间隙(PAS)增大。结论双极射频等离子舌根缩容术治疗鼾症和OSAHS有很好的可行性、有效性和安全性。[ Objectives ] To evaluate the application and effect of the bipolar radiofrequency plasma surgery system in the treatment of obstructive sleep apnea-hypopnea syndrome （OSAHS） and snoring. [Methods] 65 patients including 57 with OSAHS and 8 with snoring, in whom the other obstructive factors except in retrolingual airway space had been relieved, accepted the bipolar radiofrequency plasma surgery for volumetric reduction of tongue base （Coblation channeling of tongue base）. The symptoms of the patients, features of the polysomnography （PSG） and fiberoptic nasopharyngoscopy before and after surgery were analysed. [ Results ] Coblation channeling were done at 2 to 3 points of the tongue base. The symptoms of the patients abated significantly. The mean respiratory disturbance index （RDI） reduced from （39.4 ± 9.7） to （10.6 ± 7.4）, and the mean nadir oxygen saturation （SaO2_） raised from （68.5% ± 8.3%） to （87.6% ±6.2%）. The fiberoptic nasopharyngoscopy demenstrated volumetric raduction of the tongue base and increasing of the posterior airway space （PAS）. [ Conclusions ] Coblation channeling of tongue base have excellent feasibility, safety and efficacy in the treatment of some patients with OSAHS and snoring.

关 键 词：射频 阻塞性睡眠呼吸暂停低通气综合征 低温消融 

分 类 号：R767.1[医药卫生—耳鼻咽喉科]