翼钩牵拉及舌侧缝合在悬雍垂腭咽成形术中应用的疗效分析  

Analysis of the therapeutic effect of pterygoid hook traction and lingual suture in uvulopalatopharyngoplasty

作　　者：李刚[1] Li Gang(Otolaryngology Department of Mentougou District Hospital,Beijing,102300,China)

机构地区：[1]北京市门头沟区医院,北京京门头沟102300

出　　处：《中国医学文摘(耳鼻咽喉科学)》2025年第2期158-161,F0002,共5页Chinese Medical Digest(Otorhinolaryngology)

摘　　要：目的探讨软腭翼钩方向缝合加三角皱襞舌根侧缝合联合改良悬雍垂腭咽成形术治疗因软腭肥厚导致阻塞性睡眠呼吸暂停低通气综合征(OSAHS)患者的手术方法及疗效。方法2018年4月至2021年4月对85例软腭肥厚,腭咽平面狭窄的中重度OSAHS患者行软腭翼钩方向缝合加三角皱襞舌根侧缝合联合悬雍垂腭咽成形术,术前及术后行上气道CT等相关检查,分析85例患者手术前后的疗效及各种参数的变化情况。结果85例患者手术后1年呼吸暂停低通气指数(AHI)由(41.58±5.66)次/h降低至(12.26土3.39)次/h,差异有统计学意义(P<0.01);最低血氧饱和度由0.733±0.053提高至0.8513±0.043,差异有统计学意义(P<0.01).Epworth嗜睡量表4个指标均较术前有明显改善(P<0.01)。85例患者中治愈41例(48.2%),显效35例(41.1%),有效7例(8.2%),无效2例(2.3%),9例患者术后3个月有轻微吞咽障碍及咽痛,5例患者术后7日出现扁桃体窝出血,局部压迫后血止。结论软腭翼钩方向缝合加三角皱襞舌根侧缝合联合改良悬雍垂腭咽成形术是治疗阻塞性睡眠呼吸暂停低通气综合征的有益尝试。Objective Exploring the surgical method and efficacy of soft palate pterygoid hook direction suture combined with triangular fold lingual root side suture combined with modified uvulopalatopharyngoplasty for the treatment of obstructive sleep apnea hypopnea syndrome(OSAHS)patients due to soft palate hypertrophy.Methods From April 2018 to April 2021,85 patients with moderate to severe OSAHS with soft palate hypertrophy and velopharyngeal plane stenosis underwent soft palate pterygoid hook direction suture combined with triangular fold lingual root side suture combined with uvulopalatopharyngoplasty.Relevant examinations such as upper airway CT were performed before and after surgery,and the efficacy and changes in various parameters of 85 patients before and after surgery were analyzed.Results The apnea hypopnea index(AHI)of 85 patients decreased from(41.58±5.66)times/h to(12.26±3.39)times/h one year after surgery,with a statistically significant difference(P<0.01);The minimum blood oxygen saturation increased from 0.733±0.053 to 0.8513±0.043,with a statistically significant difference(P<0.01).All four indicators of the Epworth Sleepiness Scale showed significant improvement compared to before surgery(P<0.01).Among the 85 patients,41 were cured(48.2%),35 were significantly improved(41.1%),7 were effective(8.2%),and 2 were ineffective(2.3%).9 patients had mild swallowing disorders and pharyngeal pain 3 months after surgery,and 5 patients experienced tonsillar fossa bleeding 7 days after surgery,with local compression leading to hemostasis.Conclusion The combination of soft palate pterygoid hook direction suture and triangular fold lingual root side suture combined with improved uvulopalatopharyngoplasty is a beneficial attempt to treat obstructive sleep apnea hypopnea syndrome.

关 键 词：改良悬雍垂腭咽成形术叫 阻塞性睡眠呼吸暂停低通气综合征 软腭翼钩方向缝合 三角皱襞舌根侧缝合 

分 类 号：R766[医药卫生—耳鼻咽喉科]