以腭舌肌解剖定位的改良腭咽成形术治疗中重度OSAHS临床研究  

Clinical Study of Palatoglossus-Guided UPPP in Treatment of Moderate and Severe OSAHS

作　　者：徐志勇[1] 冀丽梅[1] 魏芳芳[1] 张俊瑶[1] 郝建海[1] 海占兵[1] XU Zhi-yong JI Li-mei WEI Fang-fang ZHANG Jun-yao HAO Jian-hai HAI Zhan-bing(Department of Otolaryngology-Head and Neck Surgery, 251st Hospital of PLA, Zhangjiakou, Hebei 075000, China)

机构地区：[1]中国人民解放军第251医院耳鼻喉科,河北张家口075000

出　　处：《河北北方学院学报（自然科学版）》2017年第4期15-17,共3页Journal of Hebei North University:Natural Science Edition

摘　　要：目的探讨依据腭舌肌解剖定位的改良腭咽成形术治疗口咽狭窄的阻塞性睡眠呼吸暂停低通气综合征(OSAHS)患者的疗效。方法对58例口咽狭窄的中重度OSAHS患者采取改良腭咽成形手术,对比术前、术后各项指标的变化,睡眠呼吸监测(PSG)结果结合病人自觉症状评价治疗效果,并以嗜睡量表(ESS)评价远期效果。结果术后经半年至3年随访,根据PSG,监测结果,治愈13例(AHI<5),显效18例(AHI<20并降低≥50%),有效22例(AHI降低≥50%),无效5例;有效率91.4%。治疗后和治疗前比较,AHI、LSaO2及ESS评分均有明显改善(P<0.01)。结论以腭舌肌解剖定位的改良腭咽成形术治疗口咽狭窄的中重度OSAHS患者,可明显改善患者生存质量,手术效果肯定。Objective To observe the therapeutic effects of modified operation of uvulopalatopharyngo- plasty （UPPP）, guided anatomically by palatoglossus on moderate and severe obstructive sleep apnea hy- popnea syndrome （OSAHS）. Methods58 cases of operation were performed on moderate and severe OS- AHS by using such a modified UPPP surgery. The changes of the indices were observed before and after operation and the long-term outcome was evaluated by sleepiness scale （ESS）. Results All cases were followed up from six months to three years after the surgery. Polysomnograpgy （PSG） data showed that 13 cases were cured （AHI〈5）, 18 cases excellently effective （AHI〈20 and decreased by≥50%） 22 cases effective （AHI decreased by≥50%）, and 14cases ineffective. The total effectiveness was 91.4%. The scores of AHI, LSaO2 and ESS after treatment were significantly improved （P〈0.01） when compared with those before treatment. Conclusion A modified operation with a palatoglossus-guided procedure in routine UPPP significantly improves disease-specific quality of life and sleep apnea symptoms in pa- tients with sleep apnea. Consequently, it is a good procedure for the treatment of OSAHS.

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 改良腭咽成形术 

分 类 号：R563.8[医药卫生—呼吸系统]