Repose 舌体牵引术治疗伴舌后坠阻塞性睡眠呼吸暂停低通气综合征患者手术适应证的疗效  

The surgical indication and modified application of suspension with Repose system for glossocoma in patients with obstructive sleep apnea hypopnea syndrome

作　　者：吴大海[1] 秦洁[1] 郭晓虹[1] 李树华[1] 

机构地区：[1]解放军沈阳军区总医院耳鼻咽喉科,110840

出　　处：《中国临床实用医学》2015年第2期29-31,共3页China Clinical Practical Medicine

基　　金：全军医学科技青年培育项目（13QNP005）

摘　　要：目的：探讨 Repose 舌体牵引术治疗伴舌后坠的阻塞性睡眠呼吸暂停低通气综合征（OSAHS）的手术适应证选择及其改良应用的疗效。方法选取2010年7月至2014年10月沈阳军区总医院耳鼻咽喉科收治的 OSAHS 患者32例，经鼻咽通气道法多道睡眠监测（NPT-PSG）确定存在舌咽区阻塞，在排除腭扁桃体下极肥大、小颌畸形、舌扁桃体肥大及下咽侧壁塌陷等因素后，于咽部 CT 舌咽区平面测量舌咽区呼吸道横截面积（S），S 值大于正常人最低值者，确定为存在舌后坠。对其进行改良 Repose 舌体牵引术并观察其临床疗效。结果术后随访3个月，复查NPT-PSG，手术前后呼吸紊乱指数（AHI）及最低血氧饱和度（LSO2）差异均有统计学意义（均P〈0.01）。结论改良 Repose 舌体牵引术是目前治疗伴舌后坠的 OSAHS 患者的一种有效手段，与传统的 Repose 手术相比易于操作。此外，建立明确的舌后坠诊断标准，进行有针对性的外科手术治疗，可以获得更好的临床疗效。Objective To analyze the surgical indication and modified application of suspension with Repose system for glossocoma in patients with obstructive sleep apnea hypopnea syndrome （OSAHS）. Methods A total of 32 patients with OSAHS were included in this study. Retroglossal obstruction was diagnosed by nasopharyngeal tube polysomnography （NPT-PSG）. After excluding hypertrophy of palatine tonsilla, micrognathia, hypertrophy of lingual tonsil and lateral hypopharyngeal wall collapse, CT scan was performed and retroglossal cross-sectional area （S） was measured. Glossocoma was determined when S was equal or greater than normal minimum value. Finally, Repose system was performed and the surgical effect was analyzed. Results At postoperative 3 month, NPT-PSG was reexamined. There were statistically significance between preoperative and postoperative measurement in all. Conclusion Modified Repose system was an effective surgical method for treating glossocoma in patients with OSAHS. Compared with traditional Repose system, it was more convenient. In addition, according to establish the diagnostic criteria of glossocoma, the surgery is performed specifically and the better effect can be achieved.

关 键 词：睡眠呼吸暂停综合征 阻塞性 舌体牵引术 舌后坠 

分 类 号：R766.43[医药卫生—耳鼻咽喉科]