舌骨悬吊联合悬雍垂腭咽成型手术的生活质量调查

Therapeutic effects of hyoid suspension and uvolopalatopharyngoplasty

目的探讨舌骨悬吊联合腭咽成型手术(UPPP)治疗重症睡眠呼吸暂停低通气综合征(OSAHS)的手术方法和效果。方法对21例符合重症OSAHS标准的患者进行了改良的UPPP+舌骨悬吊术,进行随访及对照手术前后睡眠呼吸监测结果、EPworth嗜睡量表评定和Berlin睡眠质量评估问卷调查。结果 21例术后6个月、12个月两项睡眠监测指标均较手术前有明显改变(P<0.01);EPworth嗜睡量表评分平均值分别为6.71和7.24,均较术前(16.57±1.80)明显降低(P<0.01);Berlin睡眠质量评估问卷评分平均值分别为5.57和6.14,均较术前(8.48±1.69)明显降低(P<0.01)。手术后打鼾症状明显减轻或消失,呼吸暂停次数明显减少,白天嗜睡消失或基本消失,精力充沛。根据疗效评定标准确定,术后6个月及12个月的有效率分别为100%、95.24%,但治愈率和显效率的数据有所变化。结论改良的UPPP+舌骨悬吊术手术方法简单,时间短,花费少,手术效果好,应该选择合适的病例进行治疗,进行临床推广。

Object To investigate the methodology and therapeutic effects of hyoid suspension in association with uvolopalatopharyngoplasty（UPPP） in the treatment of severe Obstructive Sleep Apnea Hypopnea Syndrome（OSAHS）.Method 21 patients with severe OSAHS underwent surgery of modified hyoid suspension in association with UPPP and were followed-up.Polysomnograms（PSG） were examined pre-operatively and post-operatively in 21 Patients.All patients were the assessed with Epworth Sleepiness Scale（ESS） and Berlin Sleep Quality Assessment Questionnaire（BSQAQ） before and after the operation.Results The results of follow-up showed that there were significant improvements in the indexes of PSG in all cases（P〈0.01）.The average of the ESS was 6.71 6 months after operation and 7.24 after one year.Also,the average of the BSQAQ was 5.57 and 6.14 respectively,with an obvious decrease compared to the pre-operative data（P〈0.01）.After surgery,the patients told about the alleviation or disappearance of snoring and much less occurrence of sleep apnea while lethargy during the day was almost completely gone.According to the assessment guidelines,the effective rate was 100% 6 months after the operation and remained at 95.24% 1 year after the operation.But cure rate and effectual rate varied.Conclusion Modified hyoid suspension in association with UPPP has advantages of simple procedure,less days of hospitalization and less expense.The effect of the operation is satisfying.Proper cases should be chosen to be treated with such procedure and more hospitals should adopt it.