舌骨悬吊联合UPPP术治疗OSAHS患者普通病房围手术期的处理

Peri-opeartive management after hyoid bone suspension and uvulopalatopharyngoplasty in normal wards

目的探讨舌骨悬吊与悬雍垂腭咽成形术（UPPP）联合手术治疗阻塞性睡眠呼吸暂停低通气综合征（OSAHS）围手术期的观察、处理的必要性。方法对78例患者术前均行多导睡眠呼吸监测，完善各系统的术前检查，并请相关科室会诊治疗相关疾病，根据情况行3～7d的正压通气治疗；术后自ICU病房转入普通病房后加强心电监护．密切观察呼吸、血压等变化，及时处理发生的问题等。结果1例术后3d因咳嗽发生继发性出血，经二次手术止血出血停止；2例颈部切口渗液，经处理后延迟愈合；6例开始进食时略有呛咳，经锻炼后在第3天消失。其余患者术后2～4d舌体运动略有受限，5～7d后舌体运动正常。结论舌骨悬吊与UPPP的联合手术治疗OSAHS有一定的潜在危险，加强国手术期的处理能显著提高患者对手术的耐受性，降低手术风险，减少并发症的发生。

Objective To study the necessity of peri-operative observation and management after hyoid bone suspension and uvulopalatopharyngoplasty（UPPP） surgery in treating obstructive sleep apnea hypopnea syndrome （OSAHS）. Methods All patients were subjected to polysomnography（PSG） and necessary preoperative examinations before the operations, and after being treated for related diseases, were subjected to CPAP for 3-7 days, and were subjected to electrocardio-monitoring after being transferred from the ICU department to the normal wards. Results One patient suffered from secondary bleeding by coughing and was subjected to a second operation. 2 cases suffered from cervical cut effusion and were healed after changing dressings. 6 suffered from bucking when eating at the beginning and were reheved after 3-day practicing. And the rest suffered a mild difficulty in moving their tongue and recovered 5 to 7 days later. Conclusions There are potential dangers after hyoid bone suspension and UPPP surgery, which can be decreased by intensive nursing.