鼻腔扩容术联合腭咽成形术治疗伴鼻塞症状阻塞性睡眠呼吸暂停低通气综合征的疗效  

Efficacy of nasal cavity expansion combined with palatopharyngoplasty in the treatment of obstructive sleep apner hypopnea syndrome with nasal obstruction

作　　者：龚辉成[1] 焦粤农[1] 谢佳[1] 刘炜 颜永毅[1] 陈菲菲[1] GONG Hui-cheng;JIAO Yue-nong;XIE Jia;LIU Wei;YAN Yong-yi;CHEN Fei-fei(Department of Otolaryngology Head and Neck Surgery,Guangzhou 12th People's Hospital,Guangzhou Otolaryngology Head and Neck Surgery Hospital,Guangzhou Medical University Otolaryngology Head and Neck Surgery Research Institute,Guangzhou 510620,Guangdong,China)

机构地区：[1]广州市第十二人民医院·广州市耳鼻咽喉头颈外科医院·广州医科大学耳鼻咽喉头颈外科研究所,广东广州510620

出　　处：《川北医学院学报》2024年第10期1361-1365,共5页Journal of North Sichuan Medical College

基　　金：广州市科技计划项目(2024A03J0492);广东省医学科研基金项目(B2024258)。

摘　　要：目的:探讨鼻腔扩容术联合腭咽成形术治疗伴鼻塞症状阻塞性睡眠呼吸暂停低通气综合征(OSAHS)的疗效。方法:选取80例伴鼻塞症状OSAHS患者为研究对象,根据手术方式不同分为对照组和观察组,每组各40例。对照组患者实施单纯腭咽成形术治疗;观察组患者实施鼻腔扩容术联合腭咽成形术治疗,术后随访6个月。比较两组患者临床疗效、鼻腔通气功能[鼻腔阻力、鼾声指数及鼻呼吸总量]、睡眠呼吸指标[呼吸暂停低通气指数(AHI)、最低动脉血氧饱和度(LSaO_(2))、血氧饱和度(SpO_(2))、深睡眠比例及觉醒指数、Epwoeth嗜睡量表(ESS)评分]及生活质量[魁北克睡眠问卷(QSQ)评分]。结果:观察组患者临床总有效率高于对照组(92.50%vs.75.00%,P<0.05)。治疗后6个月,两组患者鼻腔阻力、鼾声指数、AHI、觉醒指数及ESS评分均降低(P<0.05),且观察组低于对照组(P<0.05);鼻呼吸总量、LSaO_(2)、SpO_(2)、深睡眠比例、QSQ各维度评分及总分均升高(P<0.05),且观察组高于对照组(P<0.05)。结论:鼻腔扩容术联合腭咽成形术是一种治疗伴鼻塞症状OSAHS的有效方式,可改善患者鼻腔通气功能及睡眠呼吸参数,提升生活质量。Objective:To explore the efficacy of nasal cavity expansion combined with uvulopalatopharyngoplasty in the treatment of obstructive sleep apner hypopnea syndrome(OSAHS)with nasal obstruction symptoms.Methods:80 OSAHS patients with nasal obstruction symptoms were included.They were divided into a control group and an observation group according to different surgical methods,with 40 cases in each group.The control group was treated with simple palatopharyngoplasty,and the observation group was treated with nasal dilatation combined with palatopharyngoplasty.Both groups were followed up for 6 months after surgery.The clinical efficacy,nasal ventilation function[nasal resistance,snoring index and total nasal respiration],sleep respiratory indicators[apnea hypopnea index(AHI),lowest arterial oxygen saturation(LSaO_(2)),blood oxygen saturation(SpO_(2)),deep sleep ratio and awakening index],[Epwoeth sleepiness scale(ESS)]and quality of life[Quebec Sleep Questionnaire(QSQ)]were compared between the two groups.Results:The total effective rate in the observation group was higher than that in the control group(92.50%vs.75.00%,P<0.05).After 6 months of treatment,the nasal resistance,snoring index,AHI,arousal index and ESS of the two groups decreased(P<0.05),and the observation group was lower than the control group(P<0.05).The total nasal respiration,LSaO_(2),SpO_(2),proportion ofdeep sleep,total score of QSQ scale and the scores of each dimension of the two groups increased(P<0.05),and those of the observation group were higher than those of the control group(P<0.05).Conclusion:Nasal dilatation combined with palatopharyngoplasty is an effective combined method for the treatment of OSAHS with nasal obstruction symptoms,which can improve the nasal ventilation function and sleep respiratory parameters of patients,and improve the quality of life of patients.

关 键 词：阻塞性睡眠呼吸暂停低通气综合征 鼻塞 腭咽成形术 鼻腔扩容术 疗效 鼻腔通气功能 多导睡眠监测 

分 类 号：R762[医药卫生—耳鼻咽喉科]