H-UPPP联合内镜下低温等离子舌根切除术治疗重度OSA的对照研究  

A comparative study on treatment of severe OSA with UPPP combined with endoscopic low-temperature plasma tongue root resection

作　　者：冀永进[1] 李强[1] 张艳廷[1] 辛凤[1] 刘荣[1] 董瑞[1] 赵长青[1] JI Yongjin;LI Qiang;ZHANG Yanting;XIN Feng;LIU Rong;DONG Rui;ZHAO Changqing(Department of Otorhinolaryngology Head and Neck Surgery,Second Hospital of Shanxi MedicalUniversity,Taiyuan,030001,China)

机构地区：[1]山西医科大学第二医院耳鼻咽喉头颈外科,太原030001

出　　处：《临床耳鼻咽喉头颈外科杂志》2020年第4期324-328,共5页Journal of Clinical Otorhinolaryngology Head And Neck Surgery

基　　金：国家自然科学基金项目(No:81670914,81870707)。

摘　　要：目的:探讨改良悬雍垂腭咽成形术(H-UPPP)联合内镜下低温等离子舌根切除术(Eco-TBR)治疗重度OSA的疗效。方法:经多导睡眠监测确诊的60例重度OSA患者,其阻塞平面为口咽和舌根部,根据患者入院顺序随机分为对照组和试验组,对照组30例行单纯H-UPPP,试验组30例行H-UPPP联合Eco-TBR。应用SPSS 20.0软件包进行2组术前、术后相关数据分析。结果:57例患者完成了术前、术后主观和客观资料的随访,时间至少6个月。术后对照组治疗总有效率(41.38%)低于试验组的总有效率(67.85%),差异有统计学意义(χ2=4.03,P<0.05)。术后对照组AHI为28.07±10.283,LSaO2为72.66±6.405,ESS为12.62±2.731、snoring VAS为3.93±1.307;术后试验组AHI为25.74±14.140,LSaO2为75.36±7.299,ESS为11.32±3.209、snoring VAS为3.00±1.305。2组术后与术前AHI、LSaO2、ESS、snoring VAS分别比较差异均有统计学意义(P<0.001)。对照组和试验组术后AHI、LSaO2、ESS、snoring VAS分别比较,除snoring VAS外,差异无统计学意义(P>0.05)。结论:H-UPPP联合Eco-TBR治疗以口咽和舌根为阻塞平面的重度OSA患者的疗效确切。Objective:The aim of this study is to investigate the effect of modified uvulopalatopharyngoplasty(UPPP)combined with endoscopic hypothermic Plasma glossectomy(Eco-TBR)on the severe Obstructive sleep apnea syndrome.Method:Sixty patients with severe OSAHS were diagnosed by polysomnography,and their obstructive plane located in the oropharynx and tongue base.Patients were divided into the control group(30cases of simple H-UPPP)and the experimental group(30cases of H-UPPP combined with Eco-TBR)according to their random hospital sequence.SPSS 20.0software package was used to analyze the preoperative and postoperative data of the two groups.Result:Fifty-seven OSAHS patients had full data and a minimum 6month follow up to assess the efficacy.The total effective rate in the control group was 41.38%lower than that in the experimental group 67.85%,and the difference was statistically significant(χ2=4.03,P<0.05).The postoperative data of the control group,AHI was 28.07±10.283,LSaO2was 72.660±6.405,ESS was 12.620±2.731,and snoring VAS were 3.93±1.307.After the operation,in the experimental group,AHI was 25.74±14.140,LSaO2 was 75.360±7.299,ESS was 11.320±3.209,and snoring VAS were 3.00±1.305.The differences in AHI,LSaO2,ESS and snoring VAS before and after surgery in the two groups were statistically significant(P<0.001).After surgery,compared between the two groups,except for snoring VAS,the differences of AHI,LSaO2and ESS were not statistically significant(P>0.05).Conclusion:The effect of H-UPPP combined with Eco-TBR on severe OSAHS patients with obstructive plane of oropharynx and tongue root is definite.

关 键 词：睡眠呼吸暂停 阻塞性 改良腭咽成形术 舌根手术 消融技术 

分 类 号：R563.8[医药卫生—呼吸系统]