改良腭咽成形术合并多部位射频消融术手术疗效

Treatment of moderate or severe obstructive sleep apnea hypopnea syndrome with modified uvulopalatopharyngoplasty and temperature-controlled radiofrequency ablation

目的探讨改良腭咽成形术合并多部位低温等离子射频消融术治疗中、重度阻塞性睡眠呼吸暂停低通气综合征(obstructive sleep apnea hypopnea syndrome,OSAHS)手术疗效。方法采用改良腭咽成形术合并多部位低温等离子射频消融术治疗中重度多平面阻塞OSAHS患者83例,全部随访2年以上,术后6、12、24个月复查多导睡眠图,判定疗效。结果随访2年后,83例患者中,治愈24例(28.9%),显效28例(33.7%),有效17例(20.5%),无效14例(16.9%),总有效率83.1%;患者手术前后睡眠呼吸暂停低通气指数(apnea hypopnea index,AHI)变化有极显著统计学差异(P<0.01);重度OSAHS患者手术前后最低血氧饱和度(SaO2)有显著变化(P<0.05);全部病例均未出现严重并发症。结论改良腭咽成形术合并多部位低温等离子射频消融术是治疗中重度OSAHS安全、有效的方法。

OBJECTIVE To explore the therapeutic effect of modified uvulopalatopharyngoplasty （UPPP） combined with temperature-controlled radiofrequency ablation（TCRFA） in the treatment of moderate and severe obstructive sleep apnea hypopnea syndrome（OSAHS）. METHODS A total of 83 patients with moderate or severe OSAHS were underwent modified UPPPcombined with TCRFA. All patients were followed-up more than 2 years. Polysomnography was examined at 6 months, 1 year and 2 years after operation. RESULTS The curative rate, obvious effective rate and effective rate were 28.9 %, 33.7 % and 20.5 % respectively with a total effective rate of 83.1% at 2 years after operation. The PSG showed that, the AHI values decreased significantly（P〈0.01）in both moderate and severe OSAHS patients while the lowest values of oxygen saturation（SaO2）improved significantly only in severe OSAHS patients（P〈0.05）. No complications occurred in all patients. CONCLUSION The modified UPPP combined with TCRFA technique is an effective and safe method for the treatment of moderate or severe OSAHS.