鼻外科手术联合上气道射频消融术治疗轻中度阻塞性睡眠呼吸暂停低通气综合征  

Nasal surgery and upper airway radiofrequency ablation in patients with obstructive sleep apnea hypopnea syndrome

作　　者：王林[1] 韩薇薇[1] 牛林[1] 秦永欣[1] 刘吉祥[1] 

机构地区：[1]天津市人民医院耳鼻咽喉头颈外科天津,300121

出　　处：《临床耳鼻咽喉头颈外科杂志》2014年第3期154-156,161,共4页Journal of Clinical Otorhinolaryngology Head And Neck Surgery

摘　　要：目的:探讨鼻外科手术联合上气道射频消融术在治疗伴慢性鼻塞的轻、中度阻塞性睡眠呼吸暂停低通气综合征(OSAHS)患者的应用及疗效影响因素。方法:采用鼻外科手术联合上气道低温射频消融术对103例伴有慢性鼻塞的轻、中度OSAHS患者进行治疗。其中89例患者术后随访≥6个月,观察指标包括:BMI、Epworth嗜睡量表(ESS)评分、鼾声评分、AHI、LSaO2(%)及血氧饱和度低于0.90的时间占总睡眠时间百分比(CT90%)。结果:手术后AHI从(18.67±9.48)下降到(9.22±7.18),平均LSaO2从(0.83±0.08)上升至(0.92±0.06),ESS评分从(8.74±5.67)下降到(5.12±3.74),鼾声评分从(7.16±2.85)下降到(3.56±2.26),CT90从(18.64±12.98)下降到(10.73±8.29),各相关测量值的变化均具有统计学意义(P<0.01)。手术成功定义为AHI<10次/h且较术前下降>50%,成功率75.3%(67/89)。围手术期无严重并发症发生。结论:鼻外科手术联合上气道低温射频消融术能有效缓解打鼾及改善伴慢性鼻塞的轻、中度OSAHS患者的生活质量。Objective：To investigate the efficacy and related factors of nasal surgery combined with upper air- way radiofrequency ablation（RFA） for treatment of obstructive sleep apnea hypopnea syndrome（OSAHS） with chronic nasal blockage. Method： One hundred and three mild or moderate OSAHS patients with chronic nasal blockage were recruited, all cases had nasal surgery and upper airway RFA. All patients were evaluated by body mass index（BMI）,Epworth sleep scale（ESS）,snoring scale, and nocturnal polysomnography（PSG）. Eighty-nine patients were reevaluated at least 6 months after surgery with the preoperative methods. Result： After operation, the apnea and hypopnca index （AHI） decreased from （18.67..9.48）/h to （9.22~7.18）/h; the lowest artery ox- ygensaturation （LSaO2） increased from （0.83_--＋0.08） to （0.92~0.06） ; the Epworth sleep scale（ESS） decreased from （8.74..＋-5.67） to （5.12..3.74） ; the snoring scale decreased from （7.16..2.85） to （3.56--2.26）, the per- centage of time with oxyhemoglobin saturation below 0.90 （CTg0） decreased from （18.64.. 12.98） to （10.73 .. 8.29）. All of the differences were obvious（P〈0.01）. Success was defined as a postoperative apnea-hypopnea in- dex〈10 events per hour and at least 50~ less than the preoperative value. The surgical success rate was 75.3~ （67/89）. No major perioperative complications occurred. Conclusion： Our findings suggest that nasal surgery com- bined with upper airway RFA can improve snoring and disease-specific quality of life in patients with anatomic na- sal obstruction with mild or moderate OSAHS.

关 键 词：打鼾 射频消融 睡眠呼吸暂停低通气综合征 阻塞性 鼻中隔成形术 下鼻甲减容 

分 类 号：R563.8[医药卫生—呼吸系统]