多部位射频等离子消融术治疗阻塞性睡眠呼吸暂停低通气综合征  

Radiofrequency Plasma Ablation at Multi Spots for Obstructive Sleep Apnea Hypoventilation Syndrome

作　　者：汪永干[1] 史前妹[1] 胡春玖[1] 林忠明[1] 汪延宏[1] 胡联国[1] 毕永华[1] 谢芳[1] 周具华[1] 蔡强[1] 

机构地区：[1]安徽省铜陵市人民医院耳鼻咽喉头颈外科,铜陵244000

出　　处：《中国微创外科杂志》2011年第2期175-177,共3页Chinese Journal of Minimally Invasive Surgery

摘　　要：目的探讨多部位射频等离子消融术治疗阻塞性睡眠呼吸暂停低通气综合征（obstructive sleep apnea hypoventilation syndrome,OSAHS）的疗效。方法 2003年8月～2009年5月对30例轻、中、重度OSAHS,局麻下采用ENTCoblator等离子手术系统治疗仪和Reflex45、Reflex55刀头,分别对阻塞部位的下鼻甲、软腭、悬雍垂、舌根、扁桃体等进行消融术和射频等离子辅助下H-UPPP。术后6、12个月复查多导睡眠监测,判定疗效。结果中下鼻甲、肥厚咽侧索、扁桃体、软腭、悬雍垂、舌根1次射频消融21例,2次射频消融6例,3次射频消融3例。均未出现严重并发症。术后6个月治愈7例,显效16例,有效5例,无效2例,有效率93.3%（28/30）;术后12个月疗效：治愈5例（16.7%）,显效13例（43.3%）,有效7例（23.3%）,无效5例（16.7%）,有效率83.3%（25/30）。结论多部位低温等离子射频消融术是治疗OSAHS安全有效,患者易接受且可重复治疗,但其远期疗效尚有待观察。Objective To investigate the efficacy of radiofrequency plasma ablation at multi sites for the treatment of obstructive sleep apnea hypoventilation syndrome（OSAHS）. Methods From August 2003 to May 2009,30 cases of mild,moderate and severe OSAHS were treated under local anesthesia.ENT Coblator with Reflex45 and Reflex55 knifes were adopted to ablate the head of the middle-inferior turbinate,soft palate,uvula,root of tongue,and tonsil with the assistance by H-UPPP.All the cases were followed up for one year by polysomnography monitoring at 6th and 12th month to evaluate curative effect. Results No serious complications occurred in our cases.In the patients,21 received once ablation at the middle-inferior turbinate,soft palate,uvula,root of tongue,and tonsil,6 received twice,and 3 underwent trice.In 6 months after the operation,7 cases were cured,16 were markedly improved,5 were improved,and 2 were not improved,and the effective rate was 93.3%（28/30）.In 12 months after the operation,5 cases were cured（16.7%）,13 cases were markedly improved（43.3%）,7 cases were improved（23.3%）,and 5 were not improved（16.7%）,the effective rate was 83.3%（25/30）. Conclusion Low-temperature plasma radiofrequency ablation at multi sites is safe and effective for patients with OSAHS,who are easy to accept and repeat the treatment,but its long-term efficacy needs to be further observed.

关 键 词：射频等离子消融术 睡眠呼吸暂停低通气综合征 悬雍垂腭咽成形术 

分 类 号：R766.9[医药卫生—耳鼻咽喉科]