等离子辅助悬雍垂腭咽成形术联合舌打孔术治疗重度OSAHS  

Coblation-assisting uvulopalatopharyngoplasty combining coblation-channeling of the tongue for patients with severe OSAHS

作　　者：张庆丰[1] 宋伟[1] 佘翠萍[1] 刘得龙[1] 李大伟[1] 张欣然[1] 程晨景[1] 

机构地区：[1]大连市中心医院耳鼻咽喉头颈外科辽宁大连,116033

出　　处：《临床耳鼻咽喉头颈外科杂志》2012年第3期114-117,共4页Journal of Clinical Otorhinolaryngology Head And Neck Surgery

摘　　要：目的:探讨应用等离子辅助下的悬雍垂腭咽成形术(CAUPPP)联合舌打孔术(CCT)治疗重度阻塞性睡眠呼吸暂停低通气综合征(OSAHS)的疗效。方法:回顾性分析我科经手术治疗的重度OSAHS患者296例。术前经PSG监测:AHI≥40,LSaO2≤80%。患者均行CAUPPP联合CCT术,行CAUPPP以减容软腭,行CCT以减容舌。术后分别于6个月、12个月随访行PSG监测。结果:患者主观症状较术前明显改善,软腭功能良好,无明显鼻咽反流出现。术后与术前比较AHI值下降(P<0.01),且LSaO2升高(P<0.01)。术后有效率为91.7%。结论:重度OSAHS患者常存在多平面狭窄,CAUPPP联合CCT是一种治疗重度OSAHS的有效手术方法,具有出血少、创伤小和保留正常软腭功能等优点,值得临床推广应用。Objective：To investigate the therapeutic efficacy of coblation-assisting uvulotmlalopharyngoplanlty （CAUPPP） combining with coblatiolL-channeling of tlae tongue（CCT） for patients with severe ohslructive sleep ap- nea-hyponert syndrome（OSAHS）. Method： A retrospective analysis was rnade on patterns wilh sewere （）SAILS treated by CAUPPP combining with CCT. The adult with severe OSAHS were involved in the study and the apneahyponea index（AHI） were beyond 40/h and lowest arterial oxygen saturation（LSaOz ） were under or equal to 80%. Surgical approach： The UPPP was performed to decrease the size of soft palate with cohlation and coblalion channding in the soft palttte and decrease the size of tongue by CCT. All patiellts were followed up for 6 to 12 months and underwent polysomnography（PSG）. Result： Subjective symptoms of palients improved more signifi cantly than lhat of preopcratiou. The function of soft palate is normal without significant nasopharyngeal regurgitation. Compared wilh the preoperative data, Atll values were sigtfificantly decreased（P〈0.01 ）and the lowest oxygen saturations increased significantly（P 〈0. 01 ） and the effective rate was 91.7 %. Conclusi0n：There are usually muhiple obstruction levels in patients with severe OSAHS and the traditional surgical treamenl is not ideal, This study demonstrated thai with the assistance of eohlation, combining CAUPPP with CCT for patients with severe SAHS is an effertive surgical method. It has less blood loss, minimally invasive, retained the normal func tion of the soft palate, etc. , should be widely applied.

关 键 词：睡眠呼吸暂停低通气综合征 阻塞性 低温等离子射频 等离子辅助下的悬雍垂腭咽成形术舌打孔术 

分 类 号：R563.8[医药卫生—呼吸系统]