悬雍垂腭咽成形联合下鼻甲低温等离子射频消融术治疗重度OSAS的疗效分析  

Effect of uvulopalatopharyngoplasty combined with inferior turbinate low-temperature radiofrequency ablation in patients with severe obstructive sleep apnea syndrome

作　　者：宋富存[1] 杨阳[2] 秦永欣[2] 刘吉祥[2] 

机构地区：[1]天津医科大学研究生院,300070 [2]天津市人民医院耳鼻咽喉科

出　　处：《中国中西医结合耳鼻咽喉科杂志》2012年第3期185-188,共4页Chinese Journal of Otorhinolaryngology in Integrative Medicine

摘　　要：目的探讨悬雍垂腭咽成形术(UPPP)联合下鼻甲低温等离子射频消融术治疗重度阻塞性睡眠呼吸暂停低通气综合征(OSAS)的疗效及联合手术治疗的临床依据。方法对经临床检查和整夜睡眠监测确诊为重度OSAS的患者,而且,这些患者临床及影像学等辅助检查考虑阻塞部位以腭咽平面狭窄和单纯下鼻甲肥大为主的OSAS患者100例,随机分为两组,实验组进行UPPP联合下鼻甲消融术,对照组为单纯UPPP手术组,术后半年随访并复查PSG、ESS等进行主客观疗效评价并进行统计学分析。结果所有患者术中、术后未出现严重并发症,术后6个月复查,实验组治愈率为6.0%(3/50)、显效率44.0%(22/50)、有效率为28.0%(14/50)、总有效率为78.0%;对照组治愈率为6.0%(3/50)、显效率为36.0%(18/50)、有效率为14.0%(7/50)、总有效率为56.0%。实验组与对照组相比,总有效率差异有统计学意义(P<0.05);呼吸暂停低通气指数、最低血氧饱和度、ESS评分指标差异有统计学意义(P<0.05)。结论 UPPP联合下鼻甲低温等离子射频消融术治疗重度OSAS伴有慢性肥大性鼻炎患者疗效满意,可减轻患者分期手术的痛苦,手术创伤小,时间短,术后无严重并发症。Objective To evaluate the efficacy of uvulopalatopharyngoplasty （UPPP） combined with inferior turbinate low- temperature radiofrequency coblation （LTRC） in patients with severe obstructive sleep apnea syndrome （OSAS）. And to explore the clinical evidence of combined surgical treatment. Methods 100 patients of severe OSAS were selected who were diagnosed by clinical examination and full night polysomnography （PSG）. And all these patients had the obstructive ＇site in velopharyngeal plane with inferior turbinate hypertrophy only by clinical and imaging auxiliary examination. The subjects were randomly divided into two groups. UPPP was applied in the control group, and UPPP combined with inferior turbinate LTRC was used in the experimental group. Each patient was followed up for 6 months using PSG, the Epworth sleepiness scale （ESS）, and other subjective and objective evaluations. Results No complication was found in all patients. After 6 months, the experimental group showed cure rate of 6.0% （3/50）, obviously effective rate of 44.0% （22/50）, effective rate of 28.0% （14/50）, and with a total effective rate of 78.0%. The control group suggested cure rate of 6.0% （3/50）, obviously effective rate of 36.0% （18/50）, effective rate of 14.0% （7/50）, and with a total effective rate of 56.0%. A significant statistical difference was recognized between the two groups （P〈0.05）. The apnea/hypopnea index, lowest oxygen saturation, and ESS score were significantly improved in the experimental group compared to the control group （P〈0.05）. Conclusion The efficacy of UPPP combined with inferior turbinate LTRC in patients with severe OSAS and chronic hypertrophic rhinitis was satisfactory. The combined surgical treatment could reduce the pain, but with less minor injury and shorter operation time, and without serious complication.

关 键 词：阻塞性睡眠呼吸暂停 悬雍垂腭咽成形术 射频消融术 下鼻甲 

分 类 号：R766[医药卫生—耳鼻咽喉科]