低温等离子消融技术在上气道阻塞性病变中的应用  

Application of Coblation in Upper Airway Obstructive Lesions

作　　者：汪国武[1] 何政[1] 彭莉芬[1] 王蓉[1] 张学军[1] 黄妍雯[1] 

机构地区：[1]江西省人民医院耳鼻咽喉头颈外科,南昌330006

出　　处：《南昌大学学报（医学版）》2010年第10期50-53,共4页Journal of Nanchang University：Medical Sciences

基　　金：江西省卫生厅科技课题(20063021)

摘　　要：目的探讨低温等离子消融技术在上气道阻塞性病变中的应用。方法应用低温等离子下鼻甲打孔消融治疗鼻塞患者186例;应用等离子辅助下上气道成形术（coblation-assisted upper-airway procedures,CAUP）治疗阻塞性睡眠呼吸暂停低通气综合征（obstructive sleep apnea-hypopnea syndrome,OSAHS）患者48例。结果 186例鼻塞患者消融治疗1年后采用视觉模拟评分法（Visual analogue scale,VAS）评分：0~1分176例,2~3分10例,总有效率100%;术后并发症：鼻出血1例,鼻腔粘连1例。48例OSAHS患者治愈6例,显效19例,有效9例,无效14例,总有效率70.8%,均无出血、食物反流、开放性鼻音和鼻咽粘连等并发症发生。结论低温等离子消融技术在上气道阻塞性病变中的应用较广泛,且操作简便、并发症少、微创安全性高。对于鼻塞、非肥胖的单纯鼾症、轻中度有上气道解剖性狭窄的OSAHS患者疗效较好;对于重度OSAHS患者虽然可以解决上气道存在的阻塞,但症状改善的程度有限,仍需强调综合治疗。Objective To discuss the application of coblation in upper airway obstructive lesions.Methods Inferior turbinate coblation channeling was used in 186 patients with nasal obstruction,and Coblation-assisted upper-airway procedures（CAUP） was performed in 48 patients with obstructive sleep apnea-hypopnea syndrome（OSAHS）.Results After treatment for 1 year,the subjective estimation of nasal obstruction was assessed by the visual analog scale（VAS）.Among the 186 patients with nasal obstruction,VAS score was 0~1 in 176 and 2~3 in 10,with a total effective rate of 100%.Postoperative complications included 1 case of epistaxis and 1 case of nasal synechia.Among the 48 patients with OSAHS,6 were cured by CAUP,and CAUP treatment was significantly effective in 19 patients,effective in 9 and ineffective in 14,with a total effective rate of 70.8%.No patients had bleeding,food regurgitation,rhinolalia aperta,nasopharyngeal synechia and other complications.Conclusion Coblation is widely used in upper airway obstructive lesions with few complications,minimal trauma and high security,and has remarkable curative effects for nasal obstruction,non-obese primary snore,and mild to moderate OSAHS with upper airway stenosis.However,in severe OSAHS patients,although upper airway obstruction can be relieved by coblation,the improvement in symptoms is limited,and a comprehensive treatment is still needed.

关 键 词：等离子低温消融术 上气道 睡眠呼吸暂停 阻塞性 鼻塞 

分 类 号：R562[医药卫生—呼吸系统]