Repose系统舌骨悬吊术结合腭垂腭咽成形术对重度OSAHS合并2型糖尿病患者血糖影响的中长期比较研究  

Long- term Comparative Study on the Effect of Repose Hyoid Suspension System Combined with UPPP Surgery on Patients' Blood Glucose with Severe OSAHS and Type 2 Diabetes

作　　者：杜国平 李永德 

机构地区：[1]浙江省舟山市普陀区人民医院耳鼻喉科,316100

出　　处：《医学研究杂志》2014年第4期167-170,共4页Journal of Medical Research

摘　　要：目的比较Repose系统舌骨悬吊术结合腭咽成形术与单纯腭咽成形术手术治疗对重度阻塞性睡眠呼吸暂停低通气综合征(OSAHS)合并2型糖尿病(T2DM)患者的血糖及糖代谢的影响差异。方法选择笔者医院耳鼻喉科就诊的26例重度OSAHS合并T2DM患者按随机数字表法分为两组:联合手术组(n=14)和单腭咽成形术组(n=12)。手术前后监测所有患者FBG、PBG、FINS、GHbA1c、leptin和HOMA-IR等水平的变化情况。结果总有效率方面,术后6个月及1年组间比较,联合手术组较单纯腭咽成形术组均有显著性改善(P<0.01)。在PSG监测指标上,治疗前后两组患者在AHI和LSaO2上均有不同程度的改善,而组间比较亦有统计学差异(P<0.05)。在血糖及其代谢指标方面,除FINS外,两组患者术后6个月及1年在其他各指标上较术前均有显著性改善(P<0.05),而组间比较表明,联合手术组在FBG、PBG、GHbA1c、leptin和HOMA-IR等指标上较单手术组均有明显改善(P<0.05)。结论行Repose系统舌骨悬吊术结合腭咽成形术对重度OSAHS合并T2DM患者有极大获益,推荐临床首选。Objective To compare the different effects of repose hyoid suspension system combined with UPPP surgery with simple UPPP surgery on plasma glucose and glucose metabolism for severe OSAHS patients with type 2 diabetes mellitus （T2DM）.Methods Selected 26 patients with severe OSAHS and T2DM,whom visited our department of ENT for treatment in our hospital.They were randomly divided into two groups：the combined surgery group （n =14） and single-UPPP group （n =12）.All patients＇ FBG,PBG,FINS,GH-bA1c,leptin levels and HOMA-IR before and after surgery were monitored.Results On the total efficiency,after 6 months and 1 year between the two groups,combined surgery group was significantly better than the pure UPPP group （P ＜ 0.01）.On the PSG monitoring indicators,in the patients of two groups before and after treatment,AHI and LSaO2 improved,and the difference between two groups was significant as well （P ＜ 0.05）.On the blood glucose and their metabolites,besides of FINS,two groups after 6 months and 1 year in the other indicators were significantly improved than before surgery （P ＜ 0.05）,while the comparison between groups showed that combined surgery group showed significant improvement on FBG,PBG,GHbA1c,leptin and HOMA-IR and other indicators than single surgery group （P ＜ 0.05）.Conclusion Appling Repose hyoid suspension system combined with UPPP surgery for patients with severe OSAHS and T2DM have great benefits,and it is recommended for clinical choice.

关 键 词：Repose系统舌骨悬吊术 阻塞性睡眠呼吸暂停低通气综合征 2型糖尿病 血糖 

分 类 号：R766[医药卫生—耳鼻咽喉科]