多平面分期手术治疗阻塞性睡眠呼吸暂停低通气综合征60例  

Multiple plane operations in the treatment of obstructive sleep apnea hypopnea syndrome

作　　者：万京明[1] 刘明秋[1] 

机构地区：[1]山东省莱芜市人民医院耳鼻喉科,莱芜271100

出　　处：《中国眼耳鼻喉科杂志》2011年第6期348-350,共3页Chinese Journal of Ophthalmology and Otorhinolaryngology

基　　金：山东省星火计划项目(2008XH060)

摘　　要：目的探讨采用鼻部手术与舌根等离子射频消融及改良悬雍垂腭咽成形术(H-UPPP)多平面分期手术治疗阻塞性睡眠呼吸暂停低通气综合征(OSAHS)的疗效。方法术前检查证实同时存在鼻部和口咽部阻塞OSAHS患者60例,根据多道睡眠监测(PSG)和主观症状进行诊断和术后评估。先行鼻部手术,3个月后进行评估,无效者再行舌根等离子射频消融及H-UPPP。所有患者术后6个月及12个月进行随访评估。结果单纯鼻部手术后有效率为30%(18/60),随访1年无复发。无效的42例行舌根等离子射频消融及H-UPPP,术后6个月及12个月监测,PSG有效率分别为95.2%(40/42)和90.5%(38/42)。术前与术后6个月、12个月的呼吸暂停低通气指数、最低血氧饱和度差异均有统计学意义(P<0.05)。结论鼻部手术对部分合并鼻部和口咽部阻塞的OSAHS患者有效,联合舌根等离子射频消融及H-UPPP可显著提高手术有效率。Objective To investigate the effect of nasal surgery and multiple plane operations in the treatment of obstructive sleep apnea hypopnea syndrome （OSAHS）. Methods Sixty cases with both nasal and oral pharynx obstruc- tion were measured with polysomnography（PSC） and subjective symptoms. All the cases received nasal operations firstly, and PSG 3 months after operations. Those who did not get improvement received tongue base ablation with plasma radio- frequency and H-uvulopalatopharyngoplasty （H-UPPP）. All cases were followed up from 6 and 12 months after operations with PSG. Results Nasal operation was effective in 30% （ 18/60 ） cases with no recurrence 1 year later. The response rate of the other 42 cases who had undergone the second phase operation was 95.2% （40/42） and 90.5% （38/42）6 and 12 months postoperatively. Both the postoperative apnea hypopnea index and the lowest arterial oxygen saturation were significantly different from those of the preoperative＇s. Conclusions Nasal operation was effective for part of OSAHS patients with both nasal and oral pharynx obstruction. The response rate was significantly increased by combined tongue base ablation with plasma radiofrequency and H-UPPP.

关 键 词：睡眠呼吸暂停 阻塞性 耳鼻喉外科手术 多平面手术 

分 类 号：R766[医药卫生—耳鼻咽喉科]