低温等离子消融技术与电刀凝切技术在OSAHS中的应用效果对比  

Comparison of application effects of low temperature plasma ablation and electrosurgical coagulation on OSAHS

作　　者：刘芳卉[1] 胡乐农[1] 徐红伟[1] LIU Fanghui;HU Lenong;XU Hongwei(Department of Otorhinolaryngology Head and Neck Surgery,Lishui Municipal Central Hospital,Lishui 323000,Zhejiang,China)

机构地区：[1]浙江丽水市中心医院耳鼻咽喉头颈外科,323000

出　　处：《中国中西医结合耳鼻咽喉科杂志》2024年第1期46-50,共5页Chinese Journal of Otorhinolaryngology in Integrative Medicine

摘　　要：目的 分析比较低温等离子消融技术与电刀凝切技术在阻塞性睡眠呼吸暂停低通气综合征(OSAHS)中的应用效果。方法 回顾性分析我院92例行手术治疗的OSAHS患者临床资料,其中48例行低温等离子消融术联合悬雍垂腭咽成形术(UPPP)治疗(观察组),44例行电刀凝切UPPP治疗(对照组)。记录两组围术期指标、术后疼痛程度[视觉模拟评分法(VAS)]、术后并发症及临床疗效,比较两组术前、术后6个月多导睡眠图(PSG)参数[睡眠呼吸暂停低通气指数(AHI)、最低血氧饱和度(LSaO_(2))]变化情况。结果 两组术后创面假膜开始脱落时间及假膜彻底脱落时间、术后并发症发生率比较,差异无统计学意义(P>0.05);观察组手术时间、术中出血量均低于对照组(P<0.05)。两组术后VAS评分均逐渐降低(P<0.05),观察组术后VAS评分均低于对照组(P<0.05)。观察组、对照组分别有42、39例患者具有术后12个月的检查数据,分别有16例、11例患者具有术后24个月的检查数据;观察组术后6个月、术后12个月、术后24个月临床疗效均显著高于对照组(P<0.05)。术后6个月时,两组AHI均较术前降低(P<0.05),且观察组术后低于对照组(P<0.05);LSaO_(2)较术前升高(P<0.05),且观察组术后高于对照组(P<0.05)。结论 低温等离子消融技术术中可联合舌根部消融治疗,对中重度OSAHS近远期疗效均较好,术区损伤小,临床应用价值高。Objective To analyze and compare the application effects of low temperature plasma ablation and electrosurgical coagulation on obstructive sleep apnea-hypopnea syndrome(OSAHS).Methods The clinical data of 92 patients with OSAHS who underwent surgical treatment in the hospital were retrospectively analyzed.Among the patients,48 cases underwent low temperature plasma ablation combined with uvulopalatopharyngoplasty(UPPP)(observation group) and 44 cases received electrosurgical coagulation and UPPP therapy(control group).The perioperative indicators,postoperative pain degree [Visual Analogue Scale(VAS)],postoperative complications and clinical efficacy were recorded in the two groups,and the changes in polysomnography(PSG) parameters [apnea hypopnea index(AHI),lowest blood oxygen saturation(LSaO_(2))] of the two groups were compared before surgery and at 6 months after surgery.Results There were no statistically significant differences in the time of postoperative wound pseudomembrane shedding,complete shedding time of pseudomembrane and incidence rates of postoperative complications between the two groups(P>0.05).The surgical time and intraoperative blood loss of the observation group were shorter or less than those of the control group(P<0.05).The VAS score of the two groups was gradually decreased after surgery(P<0.05),and the VAS score after surgery in observation the group was lower than that in control group(P<0.05).There were 42 cases in observation group and 39 cases in control group with examination data at 12 months after surgery,and there were 16 cases and 11 cases with examination data at 24 months after surgery.The clinical efficacy at 6 months,12 months and 24 months after surgery was significantly higher in observation group than that in control group(P<0.05).At 6 months after surgery,the AHI of both groups was reduced compared with that before surgery(P<0.05),and the AHI in observation group was lower compared to control group after surgery(P<0.05).The LSaO_(2) was increased compared with that before

关 键 词：阻塞性睡眠呼吸暂停低通气综合征 悬雍垂腭咽成形术 低温等离子消融 电刀凝切 

分 类 号：R766.9[医药卫生—耳鼻咽喉科]