重度阻塞性睡眠呼吸暂停低通气综合征手术疗效分析

Analysis of the effects of severe obstructive sleep apnea hypopnea syndrome

目的探讨低温等离子射频消融术结合悬雍垂腭咽成形术及舌部分切除术等上气道手术治疗重度阻塞性睡眠呼吸暂停低通气综合征(obstructive sleep apnea hypopnea syndrome,OSAHS)的手术疗效,明确手术适应症的选择。方法采用低温等离子射频消融术结合悬雍垂腭咽成形术及舌部分切除术等上气道手术治疗28例重度OSAHS患者,术前、术后6个月及1年行多导睡眠仪监测,判定疗效。结果28例患者阻塞部位均为Ⅳ型,随访1年后,28例患者中,显效11例(39.3%),有效12例(42.9%),无效5例(17.9%),总有效率82.1%。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),最低血氧饱和度有显著变化(P<0.05)。结论低温等离子射频消融术结合悬雍垂腭咽成形术及舌部分切除术等上气道手术是治疗重度OSAHS安全、有效的方法。

Objective To investigate the therapeutic effect of radiofrequency ablation （RFA） combined with uvulopalatopharyngoplasty （UPPP） and glossectomy in the treatment of severe obstructive sleep apnea hypopnea syndrome （OSAHS）. Methods 28 patients with severe OSAHS were underwent RFA combined with UPPP and glossectomy. All patients were followed-up more than 1 year. Polysomnography was examined at 6 months, 1 year after operation. Results Pattern of obstruction during the level of the palate and tonguebase were observed in all patients. The obvious effective rate and effective rate were 39.3% and 42.9% respectively with a total effective rate of 82.1% at 1 year after operation. The PSG showed that the AHI values decreased significantly （P〈0.01） in severe OSAHS patients while the lowestvalues of oxygen saturation improved significantly in severe OSAHS patients（P〈0.05）. Conclusion The RFA combined with UPPP and glossectomy technique is an effective and safe method for the treatment of severe OSAHS.