改良咽侧成形术对阻塞性睡眠呼吸暂停低通气综合征患者高血压的影响  

Effects of modified lateral pharyngoplasty on hypertension in patients with OSAHS

作　　者：韩红蕾[1] 李海霞 王娜亚[1] 刘丹丹[1] 李原[1] 刘剑锋[1] 杨大章[1] 

机构地区：[1]中日友好医院耳鼻咽喉科,北京100029 [2]秦皇岛市昌黎县人民医院耳鼻咽喉科,河北秦皇岛066600

出　　处：《中国耳鼻咽喉头颈外科》2013年第4期211-214,共4页Chinese Archives of Otolaryngology-Head and Neck Surgery

摘　　要：目的探讨改良咽侧成形术对阻塞性睡眠呼吸暂停低通气综合征(OSAHS)患者高血压的影响。方法回顾性分析2004.年1月～2012年1月间在我院住院手术的以口咽部狭窄为主的OSAHS合并高血压患者的临床资料,其中38例患者行悬雍垂腭咽成形术,其余41例患者行改良咽侧成形术,分析其术前和术后的睡眠监测和血压的结果。结果悬雍垂腭咽成形术组患者中,治愈3例,显效1 5例,有效11例,总有效率76.3%。改良腭咽成形术组患者中,治愈5例,显效30例,有效6例,总有效率100%。两组患者术前和术后呼吸暂停低通气指数(AHI)相比,差异均有统计学意义。两组患者术后血压较术前都有明显下降,且部分患者减少了所需降压药物的剂量或种类,其中改良咽侧成形术组变化更明显。结论改良咽侧成形术是治疗口咽腔狭窄为主的OSAHS的更有效办法,且能同时更好的治疗其合并的高血压。OBJECTIVE To evaluate the effect of modified lateral pharyngoplasty on hypertension in patients with obstructive sleep apnea hypopnea syndrome（OSAHS）. METHODS A retrospective study was performed. Seventy-nine patients who had narrow oropharynx were included in this study. Among them, 38 patients underwent traditional uvulopalatopharyngoplasty （UPPP） and 41 patients underwent modified lateral pharyngoplasty. The polysomnography （PSG） data and blood pressure before and after operation were analyzed. RESULTS In UPPP group, 3 patients were cured, 15 patients were remarkably improved, and 11 patients were improved, the total effective rate was 76.3%. In modified lateral pharyngoplasty group, 5 patients were cured, 30 patients were remarkably improved, and 6 patients were improved, the total effective rate was 100%. For both groups, the postoperative blood pressure and AHI was significantly decreased compared with that before operation. But the effect of modified lateral pharyngoplasty on hypertension was better than UPPP. CONCLUSION The lateral phryngoplasty is a better alternative method for OSAHS patients who have narrow oropharynx. It can decrease both the apnea-hypopnea and the blood pressure.

关 键 词：睡眠呼吸暂停 阻塞性 高血压 咽侧成形术 悬雍垂腭咽成形术 

分 类 号：R766[医药卫生—耳鼻咽喉科]