阻塞性睡眠呼吸暂停低通气综合征130例临床治疗分析

Clinical Analysis of Clinical Parameters of Patients with Obstructive Sleep Apnea-hypopnea Syndrome

目的探讨阻塞性睡眠呼吸暂停低通气综合征(Obstructive Sleep Apnea-Hypopnea Syndrome,OSAHS)患者行悬雍垂腭咽成形术(Uvu-lopalalophanyngoplasty,UPPP)后的疗效分析和总结。方法选取经多导睡眠图(polysomnography,PSG)检查并确诊的OSAHS的患者130例,98例和32例分别在全麻和局麻下行UPPP手术,其中16例行预防性气管切开术。结果术后随访六个月,六个月后复查PSG,AHI出现了明显的下降(t=19.953,P<0.01),最低SaO2出现了明显的升高(t=19.953,P<0.01)。其中36例随访三年,多为中重度OSAHS患者,其术后半年恢复情况良好,但是3年后其临床疗效有所下降,AHI出现了不同程度的回升(F=98.433,P<0.01),最低SaO2出现了不同程度的下降(F=27.913,P<0.01)。结论UPPP手术治疗OSAHS是目前最有效的方法之一,手术治疗的近期效果较好,但远期疗效仍不能让人满意。

Objective We compared the sleep--apnea parameter of patients who underwent UPPP for OSAHS. Methods 130 patients diagnosed as OSAHS through polysomnography （PSG）, were brought into the investigation. 98 cases of these patients underwent UPPP in general anesthesia,and the others in local anesthesia; 16 cases underwent tracheotomy. Results All the patients were interviewed in at least half a year, half a year later, they took the examination of PSG, and then we got the new AHI and SaO2. We compared the new AHI and the old one, and found the new AHI was prominently lower than the old one （t = 19. 953,P 〈 0.01）,the new SaO2 was distinctly higher than the old one （i = 19. 953, P ~ 0.01） ,36 case with severe OSAHS were interviewed in 3 years. The clinical result was remarkable in half a year,and descends 3 years later. Conclusions UPPP is one of the most efficient clinical method for OSAHS; the short-term therapy result is good, but the long-term result is not satisfied.