悬雍垂腭咽成形术联合咽腔功能锻炼治疗阻塞性睡眠呼吸暂停低通气综合征的效果  

Effect of uvulopalatopharyngoplasty combined with pharyngeal cavity functional exercise on obstructive sleep apnea hypopnea syndrome

作　　者：廖光美 梁志晟 袁小玉 LIAO Guangmei;LIANG Zhisheng;YUAN Xiaoyu(Department of Otolaryngology,Dongguan Nancheng Hospital,Guangdong,Dongguan 523071,China)

机构地区：[1]东莞市南城医院耳鼻喉科,广东东莞523071

出　　处：《中国医药科学》2024年第19期184-188,共5页China Medicine And Pharmacy

基　　金：东莞市社会发展科技项目(2021年面上项目)(20211800903572)。

摘　　要：目的探讨悬雍垂腭咽成形术联合咽腔功能锻炼治疗中度阻塞性睡眠呼吸暂停低通气综合征(OSAHS)的临床效果。方法选择东莞市南城医院耳鼻喉科住院部2020年10月至2022年10月收治的中度OSAHS患者40例作为研究对象,按随机数表法分为对照组、治疗组,每组各20例,两组患者术前均行多导睡眠监测(PSG)、Epworth嗜睡量表(ESS)评分,均在全身麻醉下行悬雍垂腭咽成形术。术后治疗组在对照组基础上结合咽腔功能锻炼,如伸舌运动、张口训练、后鼻孔深呼吸,每日30 min,坚持锻炼6个月。术后6个月两组患者再次行PSG监测、ESS评分,观察夜间最低血氧饱和度(LSaO_(2))、睡眠呼吸暂停低通气指数(AHI),比较两组的临床疗效。结果治疗后,两组患者LSaO_(2)、AHI与治疗前相比均显著改善,差异有统计学意义(P<0.05)。治疗后,治疗组LSaO_(2)水平显著高于对照组,AHI指数显著低于对照组,差异均有统计学意义(P<0.05)。治疗6个月后,两组ESS评分均低于治疗前,差异有统计学意义(P<0.05)。结论悬雍垂腭咽成形术联合咽腔功能锻炼治疗OSAHS疗效确切,可有效降低AHI,降低夜间低氧血症,提高手术治愈率,减少复发。Objective To explore the clinical effect of uvulopalatopharyngoplasty combined with pharyngeal cavity functional exercise in the treatment of moderate obstructive sleep apnea hypopnea syndrome(OSAHS).Methods A total of 40 patients with moderate OSAHS admitted to the Department of Otolaryngology of Dongguan Nancheng Hospital from October 2020 to October 2022 were selected as the research object and randomly divided into the control group and the treatment group according to the random number table method,with 20 patients in each group.Both groups received polysomnography(PSG)and Epworth sleepiness scale(ESS)scoring before operation,and uvulopalatopharyngoplasty was performed under general anesthesia.After operation,the treatment group received pharyngeal cavity functional exercise,such as tongue extension movement,mouth-opening training,and deep breathing through postnaris,on the basis of the treatment for the control group,30 minutes every day for 6 months.Six months after operation,PSG monitoring and ESS scoring were performed again in the two groups,and the lowest oxygen saturation(LSaO_(2))at night and sleep apnea hypopnea index(AHI)were observed,and the clinical effects of the two groups were compared.Results After treatment,both groups of patients showed significant improvement in LSaO_(2)and AHI compared to before treatment,with statistical significance(P<0.05).After treatment,the LSaO_(2)level in the treatment group was significantly higher than that in the control group,and the AHI index was significantly lower than that in the control group,with statistical significance(P<0.05).After 6 months of treatment,the ESS scores in both groups were lower than before treatment,with statistical significance(P<0.05).Conclusion Uvulopalatopharyngoplasty combined with pharyngeal cavity functional exercise is effective in the treatment of OSAHS,which can effectively reduce AHI,decrease nocturnal hypoxemia,improve the surgical cure rate an d reduce recurrence.

关 键 词：睡眠呼吸暂停 咽腔功能锻炼 悬雍垂腭咽成形术 日间嗜睡 

分 类 号：R766[医药卫生—耳鼻咽喉科]