阻塞性呼吸暂停低通气综合征患者悬雍垂腭咽成形术的长期疗效及对生活质量的影响

Long-term effection of uvulopalatopharyngoplasty and quality of life in patients with obstruction sleep apnea syndrome

目的 :探讨阻塞性睡眠呼吸暂停综合征 (obstructionsleepapneasyndrome ,OSAS)患者悬雍垂腭咽成形术 (uvulopalatopharyngoplasty ,UPPP)的长期疗效和手术前后生活质量的变化。方法 :经多导睡眠监测仪(polysomnograph ,PSG)确诊的 4 2例OSHAS患者行UPPP手术 ,比较手术治疗前后Epworth嗜睡评分 (Epworthsleepscore ,ESS)和生活质量 ,分析其相关性及术后 1～ 2年的随访结果。结果 :术前OSAHS患者生活质量明显下降 ,主观问卷指标与呼吸暂停低通气指数 (apneahypopneaindex ,AHI)和最低血氧饱和度 (lowestsatura tion ,L -SAT)有明显的相关性 ;术后患者生活质量明显提高 ,但与AHI和L -SAT无明显的相关性。结论 :UPPP手术能明显提高患者的生活质量 ,但术后ESS评分变化与AHI、L -SAT之间无明显的相关性。因此 ,在UPPP手术的长期随访中 ,主观生活质量调查不能替代客观PSG监测的评估。

Objective:To evaluate the long-term effection of uvulopalatopharyngoplasty(UPPP) and quality of life in patients with obstruction sleep apnea syndrome(OSAS) before and after operation. Methods:42 patients with OSAS were diagnosed by polysomnography(PSG) and were treated by uvulopalatopharyngoplasty(UPPP). The score of ESS and the questionnaire about quality of life were surveyed before and after operation. The results in long-term follow up and the relativity were analysed after operation 1 to 2 years.Results: Before operation, the score of quality of life in patients with OSAS was greatly reduced and had a significant statistically correlation with apnea hypopnea index(AHI) and lowest saturation(LSaO 2). After operation, quality of life large improved, but there were no correlation between the score of quality of life and AHI, LSaO 2.Conclusions:UPPP can greatly improve the quality of life in patients with OSAS. However, there are not any correlation between the score of QOF and the indices of objective PSG such as AHI, LSaO 2 after operation. The subjective survey in QOF can′t replace the objective PSG in long-term follow-up of UPPP.