腭帆肌悬吊术在成人重度阻塞性睡眠呼吸暂停低通气综合征中的应用  

The application of the palatine veil muscle suspension in adults with severe obstructive sleep apnea hypopnea syn-drome.

作　　者：翟性友 李北成 陈立伟 李新建 黄邦清 彭新 刘明波 ZHAI Xing-you;LI Bei-cheng;CHEN Li-wei;LI Xin-jian;HUANG Bang-qing;PENG Xin;LIU Ming-bo(Department of Otorhinolaryngology Head and Neck Surgery,Hainan Hospital,General Hospital of PLA Hainan,Sanya 572013,Hainan,China)

机构地区：[1]中国人民解放军总医院海南医院耳鼻咽喉头颈外科,海南三亚572013

出　　处：《广东医学》2022年第5期626-630,共5页Guangdong Medical Journal

基　　金：三亚市医疗卫生科技创新项目(2018YW14)。

摘　　要：目的探讨腭帆肌外悬吊术在改良腭咽成形术(H-UPPP)和舌根低温等离子射频打孔消融术(CCT)治疗成人重度阻塞性睡眠呼吸暂停低通气综合征(obstructive sleep apnea hypopnea syndrome,OSAHS)的临床应用及对生活质量的影响。方法选取住院的成人重度OSAHS患者共52例,均采用便携式睡眠监测仪(OCST)监测,且呼吸暂停指数AHI>30次/h。随机分为观察组16例,对照1组和对对照2组各18例,观察组采用腭帆肌外悬吊辅以H-UPPP+CCT,对照1组行H-UPPP+CCT,对照2组行H-UPPP治疗,术前和术后半年均行Calgary睡眠呼吸暂停生活质量指数问卷(SAQLI)、Epworth嗜睡量表(ESS)随访进行评估。结果观察组术后半年进行SAQLI总分及4个维度(日常活动、社会交往、症状和情绪)分值、ESS分值较术前均有所改善(P<0.05)。观察组较两对照组在生活质量和Epwortht嗜睡量表评估(ESS)随访等方面表明辅以腭帆肌悬吊术后生活质量改善良好(P<0.05)。结论腭帆肌外悬吊术辅以改良悬雍垂腭咽成形术和舌根低温等离子射频打孔消融术对成人重度OSAHS患者疗效良好,主观生活质量也得到明显改善。Objective To investigate the clinical application of palatopharyngoplasty(H-UPPP)and tongue root cryogenic plasma radiofrequency perforation ablation(CCT)in the treatment of severe obstructive sleep apnea hypop-nea syndrome(OSAHS)in adults and its effect on quality of life.Methods A total of 52 adult patients with severe OS-AHS were monitored by a portable sleep monitor(OCST),with the respiratory disorder index AHI more than 30 times/h.They were randomly divided into observation group(n=16)and control group 1 and 2(n=18).The observation group was treated with external palatine vessel suspension supplemented with H-UPPP+CCT;while the control group 1 was treated with H-UPPP+CCT,and the control group 2 was treated with H-UPPP treatment.Calgary sleep apnea quality of life index questionnaire(SAQLI)and Epworth sleepiness scale(ESS)follow-up assessment were performed before and half an year after surgery.Results The total scores of SAQLI and the scores of 4 dimensions(daily activities,social interactions,symptoms and emotion)and ESS scores of the observation group were significantly improved compared with those before the operation(P<0.05).Compared with the control groups,the observation group showed a good improve-ment quality of life and ESS during follow-up,supplemented by the palatine vessel muscle suspension(P<0.05).Conclusion The extramuscular palatal sling combined with modified uvulapalatopharyngoplasty and low-temperature plasma radiofrequency perforation ablation of the base of the tongue have good curative effects in adult patients with severe OSAHS,and the subjective quality of life has been significantly improved.

关 键 词：阻塞性睡眠呼吸暂停 腭帆肌悬吊术 改良悬雍垂腭咽成形术 舌射频消融术 临床应用 生活质量 

分 类 号：R762[医药卫生—耳鼻咽喉科] R562.1[医药卫生—临床医学]