悬雍垂腭咽成形术与持续正压通气治疗OSAHS伴咽喉反流患者的疗效比较  

Application of Uvulopalatopharyngoplasty and Continuous Positive Pressure Ventilation in the Treatment of OSAHS with Laryngopharyngeal Reflux

作　　者：张小萍[1] 陈桂[1] 张明[1] ZHANG Xiao-ping;CHEN Gui;ZHANG Ming(Department of Otorhinolaryngology Head and Neck Surgery,The Affilicated First Hospital of Guangzhou Medical University,Guangzhou Guangdong 510120)

机构地区：[1]广州医科大学附属第一医院耳鼻喉头颈外科,广东广州510120

出　　处：《医学临床研究》2022年第9期1288-1290,1294,共4页Journal of Clinical Research

基　　金：国家自然科学基金项目(编号:81900927);广东省科技计划项目(编号:2013B060100005)。

摘　　要：【目的】探讨悬雍垂腭咽成形术(uvulopalatopharyngoplasty,UPPP)与持续正压通气(continuous positive airway pressure,CPAP)治疗阻塞性睡眠呼吸暂停低通气综合征(obstructive sleep apnea-hypopnea syndrome,OSAHS)伴咽喉反流(layrngopharyngeal relfux,LPR)患者的疗效。【方法】选取79例确诊为OSAHS伴LPR患者,按随机数字表法分为UPPP组(采用UPPP治疗,n=42)和CPAP组(采用CPAP治疗,n=37),比较两组患者治疗前后呼吸暂停低通气指数(AHI)、鼾声指数、立位Ryan指数、卧位Ryan指数、反流症状指数(refluxtom index,RSI)评分和反流体征评分(reflux fineling score,RFS)及平均血氧饱和度。【结果】OSAHS伴LPR患者治疗前均存在较为严重的白日嗜睡、睡眠效率减低、中重度的睡眠呼吸暂停、明显的LPR症状。治疗后,UPPP组和CPAP组患者AHI、鼾声指数、立位Ryan指数、卧位Ryan指数、RSI评分、RFS评分均较治疗前明显下降,平均血氧饱和度均较术前明显上升,差异有统计学意义(P<0.05);与CPAP组相比,UPPP组立位Ryan指数、卧位Ryan指数、RSI评分、RFS评分下降更为明显,差异有统计学意义(P<0.05)。【结论】UPPP与CPAP治疗OSAHS合并咽喉反流患者均有一定的疗效,但UPPP与CPAP相比能明显缓解患者LPR症状。【Objective】To investigate the effect of uvulopalatopharyngoplasty(UPPP)and continuous positive airway pressure(CPAP)in the treatment of patients with obstructive sleep apnea hypopnea syndrome(OSAHS)and laryngopharyngeal reflux(LPR).【Methods】A total of 79 patients with OSAHS and LPR were randomly divided into the UPPP group(n=42)and the CPAP group(n=37)according to the random number table method.Patients Aeration index(AHI),snoring index,upright Ryan index,supine Ryan index,reflux symptom index(RSI)score,the reflux symptom index(RSI)and the reflux fineling scores(RFS)before and mean oxygen saturation were recorded and compared between the two groups.【Results】OSAHS patients with LPR had severe daytime sleepiness,sleep efficiency reduction,moderate and severe sleep apnea,and obvious throat reflux symptoms before treatment.After treatment,AHI,snoring index,Ryan index,Ryan index in supine position,RSI and RFS in UPPP and CPAP group were significantly lower than those before treatment;And the mean blood oxygen saturation was significantly higher than that before treatment(P<0.05).Compared with CPAP group,the Ryan index in supine position,RSI and RFS in UPPP group were significantly lower than those in CPAP,and the difference was statistically significant(P<0.05).【Conclusion】Both UPPP and CPAP are helpful in the treatment of OSAHS with laryngopharyngeal reflux.Compared to CPAP,UPPP alleviated the symptoms of LPR better.

关 键 词：睡眠呼吸暂停 阻塞性/外科学 综合征 喉咽反流/外科学 悬雍垂/外科学 咽/外科学 腭/外科学 正压呼吸 

分 类 号：R56[医药卫生—呼吸系统]