OSAHS患者同期多平面手术前后睡眠结构的变化及疗效分析  

Changes of sleep structure before and after multiplanar surgery in OSAHS patients and analysis of curative effect

作　　者：陈惟虎[1] 胡春玖[1] 汪永干[1] 毕永华[1] 胡联国[1] 计莉 CHEN Weihu;HU Chunjiu;WANG Yonggan;BI Yonghua;HU Lianhe;JI Li(Department of Otorhinolaryngology Head and Neck Surgery,Tongling People’s Hospital,Tongling,Anhui,244000,China)

机构地区：[1]安徽省铜陵市人民医院耳鼻咽喉头颈外科,244000

出　　处：《中国中西医结合耳鼻咽喉科杂志》2019年第2期127-129,共3页Chinese Journal of Otorhinolaryngology in Integrative Medicine

基　　金：铜科【2015】40号临床实验室铜陵市卫科研[2014]22号

摘　　要：目的对阻塞性睡眠呼吸暂停低通气综合征(Obstructive sleep apnea hypopnea syndrome,OSAHS)患者一期同时进行多平面手术,探讨手术疗效,以及手术后患者睡眠结构的改变。方法对54例重度OSAHS患者同期进行鼻腔层面、腭咽层面和/或舌层面手术。术后随访6个月。比较手术前后患者Epworth嗜睡量表(The Epworth Sleeping Scale,ESS)评分、睡眠分期结构变化,并观察手术疗效。结果 54例患者术后ESS平均评分较术前下降明显(术前评分15.42±3.86;术后7.92±2.51),P<0.05。患者手术后6月复查多导睡眠监测。睡眠分期中快动眼睡眠期时间有所增加,平均从12.33±4.41%增加到19.91±2.56%。慢动眼睡眠中N1,N2期时间减少,N3期增加。54例患者中治愈9例(16.67%),显效33例(61.11%),有效9例(16.67%),无效3例(5.56%),总有效率达94.44%。结论对于不能耐受和不愿进行无创辅助通气治疗的OSAHS患者,同期行多平面狭窄的手术,具有一定的可行性。能够减轻患者临床症状,改善睡眠结构等。Objective To investigate the surgical outcome and the changes in sleep structure after surgery among patients with obstructive sleep apnea hypopnea syndrome(OSAHS) underwent multiplanar surgery in the first phase.Methods The study was performed among 54 patients with severe OSAHS undergone nasal plane,pharyngeal level and/or tongue level surgery.The patients were followed up for 6 months.The Epworth Sleeping Scale (ESS) score,sleep staging structure changes,and PSG were compared before and after surgery.Results The average score of ESS among 54 patients was significantly lower than that before surgery (preoperative score 15.42±3.86;postoperative 7.92±2.51),P<0.05.Patients were reviewed for PSG 6 months after surgery.During the sleep stage,the time of rapid eye movement sleep increased,and the average increased from 12.33±4.41% to 19.91±2.56%.In slow-motion eye sleep,N1,N2 phase time decreased,and N3 phase increased.Of the 54 patients,9(16.67%) were cured,33(61.11%) were effective,9(16.67%) were effective,3(5.56%) were ineffective,and the total effective rate was 94.44%.Conclusions It may be demonstrated from this study that for patients with OSAHS who are intolerant and unwilling to undergo non-invasive assisted ventilation,concurrent surgery for multiplanar stenosis is feasible.It can alleviate clinical symptoms and improve sleep structures of patients with OSAHS.

关 键 词：睡眠呼吸暂停低通气综合征 鼻腔扩容术 低温等离子 睡眠结构 

分 类 号：R766.9[医药卫生—耳鼻咽喉科]