Repose骨螺钉系统舌根牵引/舌骨悬吊术在多平面手术中的远期疗效分析  

The long-term effect analysis of the tongue base traction/hyoid suspension with Repose system in multiplanar surgery

作　　者：张颖 刘至玄 郑念东 王伟杰 王效军 孟明丽 王巧 曹云 李志杰 张竟超 王宇 ZHANG Ying;LIU Zhixuan;ZHENG Niandong;WANG Weijie;WANG Xiaojun;MENG Mingli;WANG Qiao;CAO Nun;LI Zhijie;ZHANG Jingchao;WANG Yu(Department of Otorhinolaryngology Head and Neck Surgery, 263 Clinical Department, Army General Hospital, Beijing, 101149, China;Department of Otorhinolaryngology, Luanping County Hospital)

机构地区：[1]陆军总医院263临床部耳鼻咽喉头颈外科,北京101149 [2]滦平县医院耳鼻咽喉科

出　　处：《临床耳鼻咽喉头颈外科杂志》2018年第9期673-677,共5页Journal of Clinical Otorhinolaryngology Head And Neck Surgery

基　　金：北京通州区科技计划(No:KJ2017CX045);陆军总医院创新培育基金(No:2016-PY-LC-05)

摘　　要：目的:探讨Repose骨螺钉系统舌根牵引/舌骨悬吊术在治疗重度OSAHS患者多平面阻塞中的远期疗效。方法:根据随访时间将患者分为短期(<12个月)对照组(30例)和远期(≥12个月)观察组(46例),比较2组患者的手术疗效。并进一步分析观察组中不同随访时间、不同手术方式患者的手术疗效及相关影响因素。结果:(1)2组患者术前各项参数差异无统计学意义,术后远期观察组的总体有效率为78.3%,较短期对照组(90.0%)明显下降,无效率由10.0%升至21.7%;(2)观察组中随着随访时间延长,术后AHI均值逐渐升高,血氧逐渐降低;手术疗效亦逐渐下降,舌根牵引组总有效率由100%降至60%,舌骨悬吊组由94.4%降至77.8%;(3)15例患者X线头影测量检查发现随着时间的延长,患者第2次复查时下咽气道间隙、后气道间隙下咽气道间隙、后气道间隙较第1次复查结果明显下降(P<0.05)。结论:Repose骨螺钉系统舌根牵引/舌骨悬吊术治疗重度OSAHS舌咽平面阻塞的疗效是肯定的,但短期的手术疗效不稳定。Objective：To explore the long-term effect of Repose bone screw system in the treatment of severe obstructive sleep apnea syndrome in patients with severe obstructive sleep apnea.Method：The follow-up group was divided into the short-term（〈12 months,control group,30 cases）and the long-term（≥12 months,observation,46 cases）.And compared the operation effect of the two groups.Furthermore,the parameters and related factors of surgical efficacy of patients with different follow-up time and different surgical methods were further analyzed.Result：（1）There was no statistical difference in the preoperative parameters of the two groups,and the overall efficiency of the postoperative long-term observation group was 78.3%,compared with 90.0%in the shortterm control group,and the inefficiencies increased from 10.0%to 21.7%.（2）In the observation group,the mean of the AHI increased gradually with the follow-up time,and the blood oxygen gradually decreased.The effectiveness of the surgical treatment gradually decreased,the total efficiency of the tongue base traction group decreased from 100%to 60%,and the hyoid suspension group decreased from 94.4%to 77.8%.（3）And 15 patients with a second review X-head shadow measurements,we found there are statistically significant（P〈0.05）in vallecula epiglottica-lateral pharyngealwall,pharyngeal airway space.Conclusion：Repose screw system of tongue base traction/hyoid suspension technique is positive in the treatment of severe OSAHS lingual pharyngeal plane obstruction,but short-term surgical results are not stable.

关 键 词：舌咽平面 舌根牵引 舌骨悬吊 睡眠呼吸暂停低通气综合征 阻塞性 

分 类 号：R563.8[医药卫生—呼吸系统]