咽腭成形术改良缝合治疗中重度阻塞性睡眠呼吸暂停低通气综合征  

Modified saturation of uvulopalatopharyngoplasty for treatment of midrange and grossly obstructive sleep apnea hypopnea syndrome

作　　者：李佳[1] 郭睿[2] 张宝林[2] 龚维熙[2] 金占国[2] 李丽[2] 

机构地区：[1]河北北方学院,河北张家口075000 [2]空军总医院耳鼻咽喉头颈外科,北京100142

出　　处：《中国耳鼻咽喉头颈外科》2012年第12期661-664,共4页Chinese Archives of Otolaryngology-Head and Neck Surgery

摘　　要：目的改进治疗阻塞性睡眠呼吸暂停低通气综合征(OSAHS)的传统术式悬雍垂咽腭成形术(UPPP)的缝合方式,探讨术后防止前后弓撕裂的方法。方法对32例中度及33例重度OSAHS患者行UPPP改良缝合,术中将腭咽弓折返减张半荷包式缝合于扁桃体窝内,手术前及术后6个月行多道睡眠图(polysomnography,PSG)监测、Epworth嗜睡量表(Epworth sleepiness score,ESS)调查及咽腔测量。结果患者睡眠结构得到明显改善,咽腔前后及左右径扩大,术后无伤口裂开。术后6个月经PSG监测、ESS调查、咽腔测量及伤口裂开的观察,有效率为87%。结论 UPPP改良缝合是防止OSAHS患者术后腭咽弓撕裂、咽部黏膜重新松弛塌陷的有效方法。OBJECTIVE To investigate the therapeutic effect of modified saturation of uvulopalatopharyngoplasty （UPPP） on obstructive sleep apnea hypopnea syndrome （OSAHS） . METHODS Thirty-two midrange and Thirty-three grossly cases of OSAHS were treated with modified saturation of UPPP. The arcus palatinus posterior was half pursestring sutured in the amygdaline pit durig the operation. Polysomnography （PSG） , Epworth sleepiness scale （ESS） and cavity of pharynx measurement were followed up for over 6 months, and compared with the preoperative condition. RESULTS The symptoms of sleepiness, oropharyngeal cavity expansion and the rate of wound dehiscence were improved obviously after 6 months. The effective rate was 94.7%. CONCLUSION The modified saturation of UPPP not only avoids dilaceration arcus palatinus posterior after operation, but also prevents pharyngeal portion mucous membrane return to the relaxation and collapse in the OSAHS patients. It can improve the effectiveness of UPPP.

关 键 词：睡眠呼吸暂停 阻塞性 改良悬雍垂腭咽成形术 

分 类 号：R766[医药卫生—耳鼻咽喉科]