悬雍垂腭咽成形术联合舌根等离子消融术治疗OSAHS的疗效观察

发布时间：2018-07-07 12:47

本文选题：睡眠呼吸暂停 + 阻塞性　；参考：《全科口腔医学电子杂志》2016年11期

【摘要】：目的探讨悬雍垂腭咽成形术联合舌根等离子消融术治疗阻塞性睡眠呼吸暂停低通气综合征(OSAHS)的疗效及其安全性。方法选取2013年6月~2014年9月我院收治的经电子鼻咽喉镜及影像学等辅助检查考虑阻塞部位以腭咽平面和舌后隙狭窄为主的OSAHS患者58例作为研究对象,对其经多道睡眠监测(PSG)检查,均行全麻下悬雍垂腭咽成形术联合舌根等离子消融术,比较患者手术治疗前后呼吸暂停低通气指数(AHI)、最低血氧饱和度(LSa O2)、Calgary生活质量指数(SAQLI)和Epworth嗜睡评分(ESS),以确定治疗疗效。结果术后6个月随访复查PSG,治愈15例、显效19例、有效18例、无效6例,总有效率为89.7%,无严重并发症发生;手术前后AHI平均值分别为(58.3±15.2)和(15.1±6.2)次/h,LSa O2平均值分别为(65.8±8.9)%和(85.9±6.4)%,SAQLI总分从术前(2.9±0.6)提高到术后(5.5±0.2),ESS评分由术前(16.5±3.2)下降到术后(6.9±1.7),差异有统计学意义(P0.05)。结论悬雍垂腭咽成形术联合舌根等离子消融术治疗以腭咽平面和舌后隙狭窄为主的重度OSAHS具有较好疗效,能有效改善OSAHS患者的生活质量。但远期疗效有待进一步观察。
[Abstract]:Objective to evaluate the efficacy and safety of uvulopalatopharyngoplasty combined with tongue root plasma ablation in the treatment of obstructive sleep apnea hypopnea syndrome (OSAHS). Methods from June 2013 to September 2014, 58 patients with OSAHS who were treated by electronic nasopharyngoscope and imaging examination and whose obstruction site was mainly located in the palatopharynx plane and the posterior lingual space were selected as the study objects. The patients were examined by polysomnography (PSG) and underwent uvulopalatopharyngoplasty combined with tongue root plasma ablation under general anesthesia. The apnea hypopnea index (AHI), lowest oxygen saturation (LSA O 2), Calgary quality of life index (SAQLI) and Epworth sleepiness score (ESS) were compared before and after operation. Results after 6 months follow-up, 15 cases were cured, 19 cases were effective, 18 cases were effective, 6 cases were ineffective, the total effective rate was 89.7, no serious complications occurred. The mean value of AHI before and after operation was (58.3 卤15.2) and (15.1 卤6.2) times / s, respectively, which were (65.8 卤8.9)% and (85.9 卤6.4)%, respectively. The total score of SAQLI increased from (2.9 卤0.6) before operation to (5.5 卤0.2) ESS after operation from (16.5 卤3.2) to (6.9 卤1.7), the difference was statistically significant (P0.05). Conclusion Uvulopalatopharyngoplasty combined with tongue root plasma ablation is effective in the treatment of severe OSAHS with palatopharynx and posterior lingual space stenosis, and can effectively improve the quality of life of patients with OSAHS. But the long-term effect needs further observation.
【作者单位】：天津市人民医院;
【分类号】：R766.9

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