计算机辅助设计的定量UPPP手术及其评价  

Computer-Aid Des igned Uvulopalatopharyngoplasty (UPPP) in the Management of Obese Patients with OS AHS

作　　者：卢晓峰[1] 唐友盛[1] 李青云[1] 朱敏[1] 邱蔚六[1] 

机构地区：[1]上海第二医科大学附属第九人民医院口腔医学院睡眠呼吸障碍诊治中心口腔颌面外科,上海200011

出　　处：《中国口腔颌面外科杂志》2003年第3期138-142,共5页China Journal of Oral and Maxillofacial Surgery

摘　　要：目的评价计算机辅助设计的UPPP的手术效果。方法采用我科自行建立的上呼吸道测量、分析系统,进行阻塞部位和程度检查;同时摄发/i/音头颅定位侧位片,测量腭咽闭合点,按一定的比例切除多余的软腭。对18例患者进行术前和术后PSG监测和头影测量分析及语音评价,检验本法的效果。结果手术成功率为88.89%,18例患者术后睡眠呼吸暂停、睡眠质量和睡眠低氧状态得到显著改善。头影测量分析显示:18例患者腭咽闭合功能良好,患者术后进食无呛咳。语音检测显示:18例患者手术前后语音功能无显著差异。结论UPPP手术成功的关键在于严格掌握手术适应证和精确计算软腭切除量。计算机辅助的定量UPPP,显著提高了手术成功率。Objective There are only40%to50%OSAHS pa ti ents who have a good response to uvulopalatopharyngo-plasty(UPPP).It is the mai n reasons that there are multipoint narrow at patients' upper airway,while UPPP can only re-lieved the narrow at the region behind soft palate,and how many tis sue at soft palate and lateral pharynx to be removed is difficult to be determin ed.UPPP treatment may cause the velopharygeal incompetence and patients may chok e while they are eating something and may have exorbitant rhinolalia while they speak.To reduce or eliminate these complications we applied the computer-aid des igned UPPP for these patients.Methods We analysised and determined the narrow an d oc-clusive site by using computer cephalometric analysis system,meanwhile we took the lateral roentgenograms for these pa-tients while they continuously sou nd/i/.We found the velopharyngeal closure point and measured the distance form v elopharyngeal closure point to the top of uvula that the excessive soft tissue i n this region could be resected safely.We e-valuated the results by PSG,cephalo metric analysis and speech examination both pre-and post-operation.Results There are88.89percent of the patients who had good response to this kind of UPPP,slee p disorder breathing in16cases were relieved and all patients had a good velopha rygeal closure while they eat or speak.Conclusion It is the key to select cor-r ectly surgical indication and to measure and remove excessive soft tissue accura tely for UPPP.Computer-aid designed UPPP increases the success rate and decrease s the complications remarkably.

关 键 词：阻塞性睡眠呼吸暂停-低通气综合征 腭垂-腭-咽成形术 计算机辅助设计 UPPP手术 鼾症 

分 类 号：R782.2[医药卫生—口腔医学]