保留悬雍垂的腭咽微波成形术的临床疗效观察

Treatment efficacy of preservation of uvulopalatopharyngoplasty by using microwave

目的:探讨腭咽微波成形术治疗腭咽平面阻塞所致的阻塞性睡眠呼吸暂停低通气综合征(OSAHS)的治疗效果。方法:对61例腭咽平面阻塞所致的OSAHS患者进行腭咽微波成形术,其中9例单纯行腭咽微波成形术,36例加双侧腭扁桃体切除术,16例加双侧腭扁桃体切除术及舌根微波消融术。结果:悬雍垂术后约2周开始回缩,约3个月接近或达到正常水平,保留咽腔的基本形态结构,无一例出现腭咽关闭不全。21例术后有咽部异物感,持续2～5个月渐消失。6个月后随访,治愈13例(21.31%),显效32例(52.46%),有效12例(19.67%),无效4例(6.56%),总有效率93.44%。结论:悬雍垂腭咽微波成形术手术时间短、出血少,术后效果满意。

Objective:To study the effect of uvulopalatopharyngoplasty (UPPP) by using microwave on obstructive sleep apnea-hypopnea syndrome(OSAHS) with Velo-pharyngeal obstruction.Method:Sixty-one cases who were diagnosed as OSAHS with Velo-pharyngeal obstruction were performed UPPP by using microwave, among which 9 cases received microwave palatopharyngoplasty only.Thirty-six cases underwent bilateral palatine tonsillectomy and another 16 cases underwent bilateral palatine tonsillectomy and tongue base microwave ablation apart from microwave pharyngoplasty.Result:Two weeks after operation, the preserved uvula began to contract.Three months after operation,the uvula contracted to be normal length and the anatomical shape.The pharyngeal cavity was preserved. No case appeared velopalatal insufficiency.Twenty-one patients felt foreign boby in pharyngeal portion, which disappeared after 2-5 months. According to the evaluation standards set in Hangzhou Conference, follow-up was carried out after 6 months. It was found that 13 cases(21.31%) were cured, 32 (52.46%) appeared significant effect, 12(19.67%) appeared effect and 4(6.56%) appeared no effect with a total effect rate of 93.44%.Conclusion:Uvulopalatopharyngoplasty by using microwave needs less time less hemorrhage and good effects.