低温等离子射频消融术多平面治疗阻塞性睡眠呼吸暂停低通气综合征26例临床体会

Clinical experience about 26 cases of using low-temperature plasma radiofrequency ablation to treat obstructive sleep apnea-hypopnea syndrome with multi-plane

目的:运用睡眠监测及定位系统准确定位及低温等离子手术系统外科技术治疗阻塞性睡眠呼吸暂停低通气综合征(OSAHS)。方法:对我院26例OSAHS患者的综合性手术方案进行回顾性研究。结果:所有患者均顺利完成手术,术中出血少,术后疼痛轻,患者术后呼吸暂停低通气指数(apnea hypopnea index,AHI)、血氧饱和度(SaO2)较术前上升明显,手术有效率达96.15%。结论:根据定位诊断,低温等离子手术系统外科技术可以单平面或同时解决鼻(下鼻甲消融)、软腭后区[等离子辅助下悬雍垂腭咽成形术(uvulopalatopharyngoplasty,UPPP)]、舌后区(舌体打孔消融)多平面阻塞,将软腭后区立体式扩宽,在明显提高手术疗效的同时,又尽可能地保留了鼻黏膜及悬雍垂的功能,有效地防止了鼻咽返流,减少了手术并发症的发生,并可以获得较好的远期疗效。

Objective： To treat obstructive sleep apnea-hypopnea syndrome（OSAHS） with multi-plane by using sleep monitoring and positioning systems to accurately locate and low-temperature plasma surgery technology.Methods： The comprehensive surgical programs of 26 patients with OSAHS in our hospital were analyzed retrospectively.Results： The surgery of all the patients were successfully completed,with less blood loss and little postoperative pain.Apnea hypopnea index and SaO2 after surgery was increased significantly compared with the preoperative.The operative efficiency was 96.15%.Conclusion： According to the locative diagnosis,the low temperature plasma technology can remove a single plane or multi-plane obstructions of the nose（inferior turbinate ablation）,after soft palate area（plasma-assisted uvulopalatopharyngoplasty） and tongue area（hole ablation of tongue）,three-dimensionally widening the posterior region of the soft palate.The surgery not only significantly improves the effect of the disease,but also keeps the nasal function and the uvula function as much as possible.At the same time,the surgery can effectively prevent nasopharyngeal regurgitation and reduce surgical complications to get the better long-term effect.