改良悬雍垂腭咽成形术联合同期鼻腔扩容术治疗阻塞性睡眠呼吸暂停低通气综合征的疗效分析  

Effect of Han-uvulopalatopharyngoplasty simultaneously combined with nasal cavity expansion for obstructive sleep apnea hypopnea syndrome

作　　者：毛敏[1] 张建国[1] 陈观贵[1] 黄敏齐[1] 黄映红[1] 杨晓彬[1] 翟锦明[1] 

机构地区：[1]广州医科大学附属第二医院耳鼻咽喉科,广州510260

出　　处：《临床耳鼻咽喉头颈外科杂志》2015年第20期1808-1811,共4页Journal of Clinical Otorhinolaryngology Head And Neck Surgery

基　　金：广东省自然基金资助(No:S2013010014907)

摘　　要：目的:探讨应用改良悬雍垂腭咽成形术(H-UPPP)联合同期鼻腔扩容术治疗阻塞性睡眠呼吸暂停低通气综合征(OSAHS)的疗效。方法:93例中重度OSAHS患者手术前后行PSG监测、鼻阻力检测、鼻塞主观视觉模拟量表(VAS)及Epworth嗜睡量表(ESS)评分,比较患者术前及术后的睡眠监测相关指标、鼻阻力及主观症状评分,分析H-UPPP联合同期鼻腔扩容术的临床疗效。结果:术后患者AHI、平均血氧饱和度、最低血氧饱和度、血氧饱和度<90%的比例、微觉醒指数、鼻阻力等客观指标以及患者白天嗜睡ESS评分、鼻塞VAS评分等主观症状较术前均有明显改善(均P<0.01),总有效率为90.32%。结论:对于存在鼻腔和咽腔平面狭窄的OSAHS患者采用H-UPPP联合鼻腔扩容术,效果良好,但应严防手术并发症的发生。Objective：To explore effect of Han-uvulopalatopharyngoplasty （H-UPPP） combined with selective nasal cavity expansion to multiplane stenosis for obstructive sleep apnea hypopnea syndrome （OSAHS）. Method： Retrospective reviews were performed for 93 patients with moderate to severe OSAHS who underwent H-UPPP and selective nasal cavity expansion technique. Every patient underwent the examinations of nocturnal polysom- nography （PSG） and rhinomanometry before and after surgery. They all filled visual analogue scale （VAS） of nasal obstruction and Epworth Sleep Scores（ESS）. Postoperative datas were obtained again about 6 months later. The preoperative and postoperative apnea-hypopnea index （AHI）, mean arterial oxygen saturation （MSaO2）, lowest arterial oxygen saturation （LSaO2）, the percentage of the total recorded time spent below 90% oxygen saturation （TS90G） and nasal resistance were compared. The patients were evaluated with VAS scores of nasal obstruction and ESS. A successful result of the surgery has been defined as achieving a reduction in AHI of at least 500/00 and/ or a residual AHI less than 20. Result： Compared with preoperative examination datas in all OSAHS patients, the AHI, TS90% significantly decreased （P〈 0.01）. The MSaO2 and LSaOz significantly increased after surgery （P〈0.01）. The efficacy rate of the patients was 90.32%. Conclusion：Combined H-UPPP and nasal cavity expan- sion technique in a single session is well tolerated and safe surgery in the treatment of OSAHS. It is effective in re- ducing respiratory parameters and subjective symptoms.

关 键 词：睡眠呼吸暂停低通气综合征 阻塞性 改良悬雍垂腭咽成形术 鼻腔扩容术 

分 类 号：R563.8[医药卫生—呼吸系统]