多平面同期手术治疗中重度OSAHS患者的安全性分析  

Safety analysis of contemporaneous multiplane operations for patients with moderate to severe obstructive sleep apnea-hypopnea syndrome

作　　者：华娜[1] 李宪华[1] 姜涛[1] 金哲[1] HUA Na;LI Xianhua;JIANG Tao;JIN Zhe(Department of Otorhinolaryngology,Zhongshan Hospital Affiliated to Dalian University,Dalian 116001,China)

机构地区：[1]大连大学附属中山医院耳鼻咽喉科

出　　处：《大连医科大学学报》2019年第3期250-253,258,共5页Journal of Dalian Medical University

摘　　要：目的探讨多平面因素所致的中重度阻塞性睡眠呼吸暂停低通气综合征(OSAHS)患者行多平面同期手术治疗的耐受性和安全性。方法对139例经多导睡眠仪监测(PSG)诊断为中重度OSAHS并接受手术干预的病例资料进行回顾性分析。其中,多平面组97例患者行以改良悬雍垂腭咽成形术(H-UPPP)为基础的多平面手术,单纯H-UPPP组42例患者仅行改良H-UPPP手术。比较两组患者在术中及住院期间急性并发症的发生情况,并对两组患者手术时间、住院时间及术后疼痛评分进行统计分析。结果多平面组与单纯H-UPPP组在气道梗阻、术后创面出血等急性并发症发生率方面无显著差异(χ^2=0.723,0.888,P>0.05)。多平面组手术时间明显长于单纯H-UPPP组[(149.95±47.01)minvs.(89.50±26.79)min],差异有统计学意义(P<0.01),两组患者术后住院时间、术后疼痛评分比较,差异无统计学意义(P>0.05)。结论多平面因素所致的中重度OSAHS患者行多平面同期手术治疗是安全可行的,虽然手术时间长,但患者可以耐受,可一次性解决上气道多个平面阻塞,达到治疗效果,缩短治疗周期。Objective To investigate the tolerability and safety of the patients with moderate to severe obstructive sleep apnea-hypopnea syndrome (OSAHS) during the period of contemporaneous multiplane operations. Methods A retrospective analysis was made on surgical cases of one hundred and thirty nine patients with moderate to severe OSAHS diagnosed by polysomnography (PSG). Among them,97 patients in the multiplane group were treated with improved uvulopalatopharyngoplasty (UPPP) based multiplanar operation,and 42 patients in group H-UPPP were only treated with improved UPPP. The two groups were compared in the incidence of acute complications,the operative time,the hospital stay and the postoperative pain scores during operation and hospitalization. Results There was no significant difference in the incidence of acute complications between the two groups in terms of airway obstruction and postoperative bleeding (χ^ 2=0.723,0.888, P >0.05). The operation time of the multiplane group was significantly longer than that of the H-UPPP group [(149.95±47.01) min vs.(89.50±26.79) min],and the difference was statistically significant ( P <0.01). There was no statistical difference between the two groups in the hospital stay after operation and the postoperative pain score ( P >0.05). Conclusion Contemporaneous multiplane operation is safe and feasible for patients with moderate and severe OSAHS caused by multi plane factors. Although the operation time is long,the patient can tolerate. It can solve multiple plane obstruction in the upper airway,achieve the therapeutic effect and shorten the treatment cycle.

关 键 词：睡眠呼吸暂停 阻塞性 多平面手术 悬雍垂腭咽成形术 

分 类 号：R737.[医药卫生—肿瘤]