悬雍垂-软腭折叠成形术治疗阻塞性睡眠呼吸暂停低通气综合征  

Application of folded soft palate plasty to obstructive sleep apnea hypopnea syndrome

作　　者：王勇[1] 李佩华 袁道勤[1] 杨桂华[1] 肖阳[1] 陈景莲[1] 刘文福[1] 

机构地区：[1]东风汽车公司花果医院耳鼻咽喉科 [2]武汉市沌口高新技术产业开发区神龙汽车公司神龙医院耳鼻咽喉科

出　　处：《中华耳鼻咽喉科杂志》2002年第6期415-417,共3页Chinese Journal of Otorhinolaryngology

摘　　要：目的　改进经典悬雍垂腭咽成型术 (uvulopalatopharyngoplasty ,UPPP)的手术方法 ,提高治疗阻塞性睡眠呼吸暂停低通气综合征 (obstructivesleepapnea hypopneasyndrome ,OSAHS)的治疗效果 ,减少术后并发症。方法　用新改进的术式治疗OSAHS患者 3 6例 ,轻度 8例 ,中度 2 1例 ,重度 7例。在常规UPPP手术基础上完整保留悬雍垂及腭肌 ,切除软腭口咽面下段 1/ 3～ 1/ 2的黏膜及黏膜下部分脂肪组织 ,再将软腭自游离缘向上折叠并与上切缘缝合 ,形成新软腭。保留软腭的活动与功能。结果　 3 1例 ( 86 1% )诉睡眠时鼾声、白天嗜睡和晨起头痛等症状明显改善。术后 6个月复查 ,3 0例( 83 3 3 % )低通气指数下降超过 5 0 % ,19例 <5次 /h ,9例≤ 2 0次 /h ,6例≤ 40次 /h。没有出现术后出血、开放性鼻音、长期饮食返流、鼻咽腔瘢痕性狭窄等并发症。结论　此改进术式在有效扩大咽腔 ,尤其是软腭后间隙的基础上 ,避免了腭咽关闭不全、饮食返流、鼻咽腔瘢痕性狭窄等并发症 。Objective To explore the effect of the modified (Uvulopalatopharyngoplasty, UPPP) where uvula is reserved completely and the soft palate is folded in the operation. Methods 36 patients with the obstructive sleep apnea-hypopnea syndrome (OSAHS) (30 men, 6 women) underwent operation. The uvula and the muscles of the soft palate were reserved completely, and the soft palate was folded during the operation. Results 31 patients (86.1%) reported improvement of snoring and daytime somnolence. 30 patients (83.33%) showed a decrease of at least 50% in the apnea and hypopnea indices (AHI). No velopalatal insufficiency occurred. Conclusion The modified UPPP not only enlarges pharyngeal cavity, but also avoids the postoperative complications. The modified UPPP could be better than the traditional operation.

关 键 词：悬雍垂-软腭折叠成形术 治疗 睡眠呼吸暂停综合征 

分 类 号：R766[医药卫生—耳鼻咽喉科]