阻塞性睡眠呼吸暂停低通气综合征手术治疗42例

Surgical treatment of obstruction sleep apnea hypopnea syndrome

目的:探讨手术治疗阻塞性睡眠呼吸暂停低通气综合征(OSAHS)的临床特征及疗效分析.方法:经多导睡眠监测确诊的OSAHS患者42例;采用多层螺旋CT评估上气道阻塞部位;针对不同平面的阻塞分别采用鼻中隔矫正术、下鼻甲部分切除术以及用于鼻窦炎鼻息肉所致的鼻内镜手术、悬雍垂腭咽成形术(UPPP)及舌根舌体减容手术.结果:手术后睡眠呼吸暂停及低通气指数(AHI)、呼吸暂停指数(AI)、最长呼吸暂停时间、最长低通气时间、最低血氧饱和度均比手术前有改善,差异有统计学意义(P<0.01).结论:上气道狭窄和局部软组织塌陷性增强是导致OSAHS发生的主要原因,多平面联合手术是治疗OSAHS的有效方法,有助于降低OSAHS患者心脑血管疾病的发病率和死亡率.

AIM：To explore the clinical characteristics and curative effect of surgical treatment of obstructive sleep apnea hypopnea syndrome （OSAHS）. METHODS：Polysomnogram confirmed 42 cases of patients with OSAHS and multi-layered screw CT was used to evaluate the sites of upper airway obstruction. In line with different plane of obstruction,partial inferior turbinectomy,endoscopic surgery for nasosinusitis and rhinopolypus,uvulopalatopharyngoplasty （UPPP） or the tongue-reduction surgery was applied. RESULTS：The postoperative sleep apnea and hypopnea index （AHI）,apnea index （AI）,the longest apnea,the longest hypopnea and minimum oxygen saturation were improved compared with those preoperative,with significant difference （P〈0.01）. CONCLUSION：The upper airway constriction and partial collapse of soft tissue leading to increased occurrence of OSAHS. Multi-plane operation is an effective treatment of OSAHS,which reduces the cardiovascular disease morbidity and mortality in OSAHS patients.