成人阻塞性睡眠呼吸暂停低通气综合征的上气道多平面外科治疗

Multilevel surgery of the upper airway for adults with obstructive sleep apnea-hypopnea syndrome

阻塞性睡眠呼吸暂停低通气综合征(OSAHS)患者睡眠时频繁发生低氧及高碳酸血症,最终导致全身多系统、多器官渐进性损害。目前除了非手术的经鼻持续正压通气治疗(nCPAP)外,手术仍是主要的治疗措施。OSAHS上气道阻塞部位包括鼻腔、鼻咽、口咽与下咽,可单一或多部位阻塞,根据上气道的阻塞平面及范围,从而进行有针对性的手术是提高疗效的关键。文章就OSAHS外科治疗的历史、基于阻塞部位的临床分型及不同阻塞部位外科术式的选择、疗效评价等做了综述。

Hypoxemia and hypercapnia frequently occur in adults with obstructive sleep apnea-hypopnea syndrome（OSAHS） during sleep,leading to progressive impairments of multiple systems and organs.In addition to nasal continuous positive airway pressure（nCPAP）,surgical treatment for OSAHS is an important means.Nasal,nasopharyngeal,oropharyngeal and hypopharyngeal obstruction,acting alone or in combination,are frequently identified as the causes of OSAHS.To improve efficacy,it is vital to make an individual plan for every patient according to the sites of obstruction.This article reviewed the history of surgical treatment,clinical classification and surgical efficacy on the basis of the sites of obstruction and surgical plans.