切除腭腱膜和部分硬腭骨质致软腭整体前移治疗OSAHS临床疗效分析

Clnical analysis of the patient with OSAHS by removal the part of the hard palata and the palatine aponeurosis to make transpalatal advancement

目的探讨应用切除腭腱膜和部分硬腭骨质缩短软腭前后径从而致软愕整体前移治疗因鼻咽平面狭窄阻塞性睡眠呼吸暂停综合征(obstructive sleep apnea hypopnea syndrome,OSAHS)患者的方法。方法对经muller动作检测确定的鼻咽阻塞平面所致的睡眠呼吸暂停患者进行了切除腭腱膜,形成可移动的软腭瓣,并且凿除部分硬腭后缘骨质致软腭整体前移。22例中19例行常规扁桃体切除术,并进行了术前术后多导睡眠观测。结果术后半年复查,按照杭州会议标准,总有效率为100%。且术前术后比较差异有统计学意义(P<0.001)。结论切除腭腱膜缩短硬腭骨质致软腭整体前移是治疗鼻咽平面阻塞的OSAHS的一个有效的方法。

Objectlve To investigate the effect of the patient with obstructive sleep apnea hypopnea syndrome （OSAHS） by means of removal the palatine aponeurosis and the hard palate to make transpalatal advancement. Methods Twenty -two OSAHS patients in nasopharyngeal apnea examined by Mullers method had been operated to make the soft palate advancement. 19 cases had a tonsillectomy by dissection and PSG observation was done before and after the operation. Results The total efficieney was 100% six months later after the operation, according to the standard of Hang Zhou meeting. The statistics differences were obvious （P 〈 0.01 ）. Conclusions Removal of the palation aponeurosis and part of the hard palate to make palate advancement is an effective method in treating patient with OSAHS.