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目的观察鼻咽联合成形术治疗阻塞性睡眠呼吸暂停低通气综合征(OSAHS)的疗效。方法选择经多道睡眠呼吸监测(PSG)检查确诊的OSAHS患者68例,以咽腔狭窄为主,同时合并鼻腔阻塞。同期行解除鼻腔阻塞及保留悬雍垂的腭咽成形术(H-UPPP)。术后进行心电监测48 h,随访1年,记录睡眠呼吸暂停低通气指数(AHI)及最低血氧饱和度(LSaO2),并进行手术前后疗效比较。结果术后均无因呼吸困难、无手术并发症发生及气管切开者。术后1年AHI为(15.2±10.8)次/h,LSaO2为86%±15%,Epworth嗜睡量表(ESS)评分为(6.1±3.4)分,均较术前明显改善(P均<0.05)。术后1年所有患者打鼾、憋气、嗜睡、头痛等症状明显减轻或消失。治愈18例,好转38例,有效12例。结论鼻咽联合成形术治疗OSAHS患者可改善鼻腔通气,疗效可靠,并未明显增加手术风险。
Abstract：[1]Won CH,Li KK,Guilleminault C.Surgical treatment of obstructivesleep apnea:upper airway and maxillomandibular surgery[J].ProcAm Thorac Soc,2008,5(2):193-199.
[2]Yaremchuk K,Tacia B,Peterson E,et al.Change in epworthsleepiness scale after surgical treatment of obstructive sleep apnea[J].Laryngoscope,2011,121(7):1590-1593.
[3]Olszewska E,Rutkowska J,Czajkowska A,et al.Selected surgicalmanagements in snoring and obstructive sleep apnea patients[J].Med Sci Monit,2012,18(1):CR13-18.
[4]中华医学会耳鼻咽喉科学分会,中华耳鼻咽喉科杂志编委会.阻塞性睡眠呼吸暂停低通气综合证诊断依据和疗效评定标准暨悬雍垂腭咽成形术适应证(杭州)[J].中华耳鼻咽喉科杂志,2002,37(6):403-404.
[5]Riha RL,Gislasson T,Diefenbach K.The phenotype and genotypeof adult obstructive sleep apnoea/hypopnoea syndrome[J].Eur Re-spir J,2009,33(3):646-655.
[6]Lavie L,Lavie P.Molecular mechanisms of cardiovascular diseasein OSAHS:the oxidative stress link[J].Eur Respir J,2009,33(6):1467-1484.
[7]古庆家,汪审清,梁传余.阻塞性睡眠呼吸暂停低通气综合征手术治疗进展[J].中国医学文摘耳鼻咽喉科学,2006,21(3):176-178.
[8]罗志强,敬前程.H-UPPP及等离子辅助的H-UPPP治疗OSAHS的临床对比研究[J].临床耳鼻咽喉头颈外科杂志,2011,25(6):258-261.
[9]Yuan PX,Hong LY,Shan KY,et al.Predictors of surgical out-comes of uvulopalatopharyngoplasty for obstructive sleep apnea hy-popnea syndrome[J].Otolaryngol Head Neck Surg,2011,145(6):1049-1054.
[10]Edward M,Weaver B,Tucker W,et al.Studying life effects&ef-fectiveness of palatopharyngoplasty(SLEEP)study:subjectiveoutcomes of isolated uvulopalatopharyngoplasty[J].OtolaryngolHead Neck Surg,2011,144(4):623-631.
[11]Robinson S,Chia M,Carney AS,et al.Upper airway reconstruc-tive surgery long-term quality-of-life outcomes compared with CPAPfor adult obstructive sleep apnea[J].Otolaryngol Head Neck Surg,2009,141(2):257-263.
[12]Douglas H,Cowan MD,Ann R,et al.Upper Airway Surgery forthe Treatment of Obstructive Sleep Apnea:Surgical Outcomes andthe Effect on CPAP[J].Otolaryngol Head Neck Surg,2011,145:P276.
[13]彭涛,李志勇,李红光,等.鼻部手术联合悬雍垂腭咽成形术治疗OSAHS疗效分析[J].四川医学,2010,31(6):798-799.
[14]杨素芳,马文成,侯昭晖,等.悬雍垂腭咽成形术联合鼻部手术治疗OSAHS疗效分析[J].军医进修学院学报,2010,31(2):140-141.
[15]Regli A,von Ungern-Sternberg BS,Strobel WM,et al.The im-pact of postoperative nasal packing on sleep-disordered breathingand nocturnal oxygen saturation in patients with obstructive sleepapnea syndrome[J].Anesth Analg,2006,102(2):615-620.
基本信息:
中图分类号:R766.9
引用信息:
[1]朱新华,廖兵,王心悦,等.鼻咽联合成形术治疗OSAHS临床疗效观察[J].山东医药,2012,52(10):80-82.
基金信息:
江西省卫生厅科技计划项目(20081076)
2012-03-16
2012-03-16