腭咽成形术中保留悬雍垂对疗效及生活质量的影响

Clinical value of preservation of uvula in uvulopalatopalatopharyngoplasty

目的探讨保留悬雍垂对悬雍垂腭咽成形术(uvulopalatopharyngoplasty,UPPP)的疗效、术后并发症及术后生活质量的影响。方法67例阻塞性睡眠呼吸暂停低通气综合征(obstructive sleep apnea hypopnea syndrome,OSAHS)患者,42例行保留悬雍垂的改良UPPP(H-UPPP组),25例行不保留悬雍垂的UPPP(传统UPPP组)。比较两组的疗效、术后并发症发生率及术后生活质量。结果H-UPPP组与传统UPPP组相比较,术后3个月手术总有效率为80.95%和84.00%,术后1年为66.67%和72.00%,差异均无显著性(P>0.05);术后疼痛得分为5.64±2.21和7.12±3.24,差异有显著性(P<0.05);术后鼻咽反流发生率为28.57%和60.00%,差异有显著性(P<0.05);术后开放性鼻音发生率为35.71%和64.00%,差异有显著性(P<0.05);术后出血、咽部不适及术后1年咽干发生率差异无显著性(P>0.05)。结论与传统UPPP相比较,H-UPPP手术有效率没有降低,术后并发症发生率较低,患者生活质量较高。

OBJECTIVE To investigate the clinical value of preservation of uvula in uvulopalato palatopharyngoplasty （UPPP）. METHODS UPPP was performed on 67 cases with obstructive sleep apnea hypopnea syndrome （OSAHS）. The uvula was reserved in 42 cases and was not reserved in 25 cases. The therapeutic effectiveness, postoperative quality of life and complications between two groups were compared. RESULTS The short-term curative effectiveness were 80.95 % and 84.00 %, the long term curative effectiveness were 66.67 % and 72.00 % in H-UPPP and UPPP group respectively. There was no significant difference between two groups （P 〉 0.05）. The painfulness score was 5.64±2.21 and 7.12± 3.24 in H-UPPP and UPPP group respectively. The difference was significant （P〈 0.05）. The incidence of nasopharyngeal refluxing was 28.57 % and 60.00 % in H-UPPP and UPPP group respectively. The difference was significant （P〈 0.05）. The incidences of rhinolalia aperta were 35.71% and 64.00 % in H-UPPP and UPPP group respectively. The difference was significant （P〈0.05）. CONCLUSION Reserving uvula in UPPP can reduce the postoperative complication and enhance the quality of life without decreasing the therapeutic effectiveness.