同期多平面手术治疗中重度阻塞性睡眠呼吸暂停低通气综合征的疗效  

Comprehensive evaluation on the effect of simultaneous multi-level surgery for moderate to severe OSAHS

作　　者：戴吉[1] 陈锐[2] 曹忠胜[1] 袁辉[1] 赵振安 辛洁[1] 罗颜[1] 卫红齐[1] 李文全[1] 

机构地区：[1]苏州大学附属第二医院耳鼻咽喉科,215000 [2]苏州大学附属第二医院睡眠中心,215000

出　　处：《实用医学杂志》2015年第5期753-756,共4页The Journal of Practical Medicine

摘　　要：目的:探讨同期多平面手术治疗中重度阻塞性睡眠呼吸暂停低通气综合征(OSAHS)的疗效。方法:对137例经多导睡眠仪监测(PSG)诊断为中重度OSAHS并接受手术干预的病例资料进行回顾性分析。其中,多平面组95例患者行以改良悬雍垂腭咽成形术(UPPP)为基础的多平面手术,UPPP组42例患者仅行改良UPPP。比较其术后并发症的发生情况,并对术前和术后PSG检查、Calgary睡眠呼吸暂停生活质量指数问卷(SAQLI)、Epworth嗜睡量表(ESS)和鼾声评分(SS)相关检测数据进行统计分析。结果 :仅多平面组出现急性呼吸道梗阻1例(1.1%),经及时行气管切开术症状缓解。术后多平面组AHI、LSa O2、TS90%和SAQLI总分及4个维度分值、ESS分值、SS分值较术前均有明显改善(P<0.01),且优于UPPP组(P<0.05)。而UPPP组仅AHI、LSa O2、TS90%有改善(P<0.05)。结论:同期多平面手术是治疗OSAHS患者安全可行的方法。主观量表和客观检查综合评估能更全面、准确地反映手术疗效和疾病对OSAHS患者生活质量的影响。Objective To investigate the effects of simultaneous multi-level surgery for moderate to severe obstructive sleep apnea hypopnea syndrome （OSAHS）. Methods A retrospective analysis was made on surgical cases of one hundred and thirty seven patients with moderate to severe OSAHS diagnosed by polysomnography （PSG）. They were divided into multi-level group （n = 95） and UPPP group （n = 42）. The two groups were compared in terms of postoperative complications as well as the related indicators of PSG , calgary sleep apnea quality of life index （SAQLI）, epworth sleepiness scale （ESS）, snore scales （SS） before operation and after operation. Results Just one patient in the multi-level group had difficulties in respiration and was rescued by timely tracheotomy. The AHI, LSaO2, TS90%, the total score and the scores on the four dimensions of SAQLI, ESS score, SS score in the multi-level group were significantly improved as compared both to the results after operation （P 〈 0.01） and to the UPPP group （P 〈 0.05）. But only the AHI, LSaO2 and TS90% in the UPPP group were improved （P 〈 0.05）. Conclusions The multi-level surgery is a safe and feasible therapy or moderate to severe OSAHS. The evaluation in subjective and objective ways can be more accurate in comprehensive reflecting the surgical efficacy and effects of OSAHS on patients′ of life quality.

关 键 词：睡眠呼吸暂停 阻塞性 耳鼻喉外科手术 治疗结果 生活质量 

分 类 号：R766.9[医药卫生—耳鼻咽喉科]