阻塞性睡眠呼吸暂停低通气综征手术治疗的临床研究

发布时间：2018-06-13 23:29

本文选题：阻塞性睡眠暂停低通气综合征 + 悬雍垂腭咽成形术　；参考：《中国临床解剖学杂志》2014年04期

【摘要】：目的观察阻塞性睡眠呼吸暂停低通气综合征(obstructive sleep apnea hypopnea syndrome,OSAHS)住院患者的手术方式和疗效,探讨如何根据患者病情选择合适的手术治疗方案。方法选择OSAHS患者共40例,根据手术方式不同将患者分为3组,单纯用低温等离子射频消融术辅助下悬雍垂腭咽成形术24例(1组),同时行鼻内镜手术和低温等离子射频消融术辅助下悬雍垂腭咽成形术8例(2组),鼻腔和咽腔分期手术8例(3组)。分别在患者术前和术后3个月行多导睡眠呼吸监测。统计患者的睡眠呼吸暂停低通气指数(Apnea-hypopnea index,AHI)和最低血氧饱和度指标。结果 1组患者中治愈3例,显效15例,,有效6例。2组患者中治愈6例,显效2例。3组分期手术患者首次手术显效2例,有效4例,无效2例。二次手术后治愈6例,显效2例。结论对单纯软腭平面阻塞的患者,低温等离子射频消融术辅助下悬雍垂腭咽成形术疗效显著,同时合并有鼻腔平面阻塞的患者,仅行悬雍垂腭咽成形术手术疗效欠佳,需二期行鼻内镜手术或同时进行两个部位手术。
[Abstract]:Objective to observe the operative methods and efficacy of obstructive sleep apnea hypopnea syndrome (OSAHS) patients with obstructive sleep apnea hypopnea syndrome (OSAHS), and to explore how to select the appropriate surgical treatment scheme according to the patients' condition. Methods 40 patients with OSAHS were selected and divided into 3 groups according to different surgical methods. 24 cases of uvulopalatopharyngoplasty assisted by low temperature plasma radiofrequency ablation were performed in group 1, and 8 cases of uvulopalatopharyngoplasty assisted by low temperature plasma radiofrequency ablation were performed with nasal endoscopy and low temperature plasma radiofrequency ablation. Stage operation 8 cases, 3 groups. Polysomnography was performed before and 3 months after operation. The apnea-hypopnea index (Apnea-hypopnea index) and the lowest oxygen saturation index were measured. Results in group 1, 3 cases were cured, 15 cases were effective, 6 cases were cured in group .2, 2 cases were effective in group .3, 2 cases were effective, 4 cases were effective and 2 cases were ineffective. 6 cases were cured and 2 cases were effective after secondary operation. Conclusion the effect of uvulopalatopharyngoplasty assisted by low temperature plasma radiofrequency ablation is significant in patients with simple soft palate level obstruction, and the effect of uvulopalatopharyngoplasty is not good in patients with nasal plane obstruction. Two-stage endoscopic surgery or two site operations are required.
【作者单位】：南方医科大学第三附属医院耳鼻咽喉头颈外科;
【分类号】：R766

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