阻塞性睡眠呼吸暂停低通气综合征的生物力学原理  

The biomechanics theory of uvulopalatopharyngoplasty in obstructive sleep apnea hypopnea syndrome

作　　者：张文华[1] 张玉庚[2] 孙沛涌[2] 时文杰[2] 

机构地区：[1]天津市武清区人民医院,天津301700 [2]天津市第一中心医院,天津300192

出　　处：《武警后勤学院学报（医学版）》2014年第6期474-477,共4页Journal of Logistics University of PAP（Medical Sciences）

摘　　要：【目的】探讨悬雍垂腭咽成形术(uvulopalatopharyngoplasty,UPPP)治疗阻塞性睡眠呼吸暂停低通气综合征(obstructive sleep apnea hypopnea syndrome,OSAHS)的生物力学原理。【方法】对45例OSAHS患者的BMI与AHI、最低SaO_2、平均SaO_2相关性进行研究,根据腭咽间隙解剖学及生物力学原理设计UPPP手术方法,对比术前术后AI、AHI、最低SaO_2及平均SaO_2,统计手术疗效。【结果】45例中95.56%肥胖,且均有腭咽间隙狭窄,其BMI与AHI、最低SaO_2、平均SaO_2显著相关。据生物力学原理设计的UPPP手术方法,术后AI(18.73±17.90)、AHI(27.24±20.89)、最低SaO_2(69.84±13.66)%及平均SaO_2(90.99±3.71)%均较术前有明显的改善,差别有统计学意义(P<0.01)。近期总有效率84.62%;远期总有效率68.42%。【结论】UPPP是治疗OSAHS的有效方法,其生物力学原理是增大腭咽开放力,减小关闭力.以达到新的适当的腭咽开放力和关闭力的平衡。【Objective】To investigate the biomechanics principles of uvulopalatopharyngoplasty（UPPP） in the treatment of obstructive sleep apnea hypopnea syndrome（OSAHS）.【Methods】45 cases of OSAHS patients were researched studied in the correlation of body mass index（BMI）,apnea hypopnea index（AHI）,lowest arterial oxygen saturation and average arterial oxygen saturation.UPPP surgery method were designed according to the principle of anatomy and biomechanics theory of palatopharyngeal space.Preoperative and postoperative AI AHI and lowest SaO2 and average SaO2 were reorded and compared.【R6SUlts】95.56%of 45 cases were obese,and with narrow palatopharyngeal space,the BMI was significant associated with AHI,lowest SaO2,and average SaO2.According to the biological mechanics principle design of UPPP surgery methods,postoperative AI,AHI,lowest SaO2 and average SaO2 were improved（P〈0.01）,the difference was statistically significant.Short term total effective rate was 84.62%.Long-term total effective rate was 68.42%.【Conclusion】 UPPP is an effective method for treating of OSAHS,theory can not only increase the opening strength but also decrease the palatopharyngeal closure muscles＇ tensile force,and these two may achieve normal balance.

关 键 词：阻塞性睡眠呼吸暂停低通气综合征 悬雍垂腭咽成形术 腭咽间隙 生物力学原理 

分 类 号：R766.4[医药卫生—耳鼻咽喉科]