阻塞性睡眠呼吸暂停低通气综征手术治疗的临床研究

于巧莲, 田广永

中国临床解剖学杂志 ›› 2014, Vol. 32 ›› Issue (4) : 484-486.

中国临床解剖学杂志 ›› 2014, Vol. 32 ›› Issue (4) : 484-486. DOI: 10.13418/j.issn.1001-165x.2014.04.027
临床研究

阻塞性睡眠呼吸暂停低通气综征手术治疗的临床研究

  • 于巧莲, 田广永
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Clinical study of the surgical treatment on obstructive sleep apnea hypopnea syndrome

  • YU Qiao-lian, TIAN Guang-yong 
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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 explore surgical treatment methods we analyse OSAHS cases of inpatien department. Methods 40 cases underwent 3 different surgical treament methods.  According to surgerical methods, 40 cases were divided into 3 groups: low temperature coblation-assisted uvunlopalatopharyng oplasty (first group, 24 cases), low temperature coblation-assisted uvunlopalatopharyngoplasty and nasal endoscopic surgery at one time (second group, 8 cases), low temperature coblation-assisted uvunlopalatopharyngoplasty and nasal endoscopic surgery at two times (third group, 8 cases). Patient charts were reviewed and preoperative and postoperative apnea-hypopnea index 3 months after the surgery (AHI), minimum oxygen saturation were evaluated. Result In the first group, the effect was successful in 3cases, excellent in 15 cases, good in 6 cases. In the second group, the effect was successful in 6 cases, excellent in 2 cases. In the third group before second operation, the effect was excellent in 2 cases, good in 4 cases and useless in 2 cases. After the second operation, the effect increased to bieng successful in 6 cases, excellent in 2 cases. Conclusions A significantly high operation success rate can be expected after surgical correction with low temperature coblation-assisted uvunlopalatopharyngoplasty for soft palate obstruction after whereas a low operation success rate can be found in the third group before their second operation. Both low temperature coblation-assisted uvunlopalatopharyngoplasty and nasal endoscopic surgery are needed when nasal and palate obstructions are present.

关键词

 阻塞性睡眠暂停低通气综合征 / 悬雍垂腭咽成形术 / 低温等离子射频消融术

Key words

Obstructive sleep apnea hypopnea syndrome / Uvunlopalatopharyngoplasty / Low temperature coblation

引用本文

导出引用
于巧莲, 田广永. 阻塞性睡眠呼吸暂停低通气综征手术治疗的临床研究[J]. 中国临床解剖学杂志. 2014, 32(4): 484-486 https://doi.org/10.13418/j.issn.1001-165x.2014.04.027
XU Qiao-Lian, TIAN An-Yong. Clinical study of the surgical treatment on obstructive sleep apnea hypopnea syndrome[J]. Chinese Journal of Clinical Anatomy. 2014, 32(4): 484-486 https://doi.org/10.13418/j.issn.1001-165x.2014.04.027
中图分类号: R765   

参考文献


[1]  林其昌,黄建钗,丁海波,等. 福州市20岁以上人群阻塞性睡眠呼吸暂停低通气综合征流行病学调查
[J].中华结核和呼吸杂志,2009,32(3):193-197.

[2]  杨彩琴,郭红东,王志宏,等. 改良UPPP在阻塞性睡眠呼吸暂停低通气综合征中的疗效观察,2009,23(24):1147-1148.

[3]  蒋桃根,晁杰伟,曹剑,等.诱导睡眠下电子喉镜在阻塞性睡眠呼吸暂停低通气综合征定位诊断中的临床应用
[J].临床耳鼻咽喉头颈外科,2008,22(6):260-262.

[4]  中华医学会耳鼻咽喉科学分会.中华耳鼻咽喉头颈外科杂志编委会.阻塞性睡眠呼吸暂停低通气综合征诊疗指南草案
[J]. 中华耳鼻咽喉头颈外科杂志,2007,42:83-84.

[5] Young D, Collop N. Advances in the treatment of obstructive sleep apnea
[J].Curr Treat Options Neurol, 2014, 16(8):305 -306.

[6]  叶京英.阻塞性睡眠呼吸暂停低通气综合征的外科治疗策略
[J].中华耳鼻咽喉头颈外科杂志,2006,41( 2) : 81 -84.

[7]  冯春英,周敬淳,柯朝阳,等. 腭舌结构特点与改良腭咽成形及舌根消融术治疗重度OSAHS的临床意义
[J].中国临床解剖学杂志,2013,31(5):604-607.

[8]  郭秋霞.低温等离子射频消融术辅助治疗 OSAHS 的临床观察
[J].中国伤残医学,2014,22(6):154-155.

[9]  周玫,江满杰,李泽卿,等.改良腭咽成形术合并多部位射频消融术手术疗效
[J].中国耳鼻咽喉头颈外科,2007,14(2):112-115.


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