改良H—UPPP治疗阻塞性睡眠呼吸暂停低通气综合征

Revised H-UPPP in the treatment of obstructive sleep apnea/hyponea syndrome

目的将保留悬雍垂的腭咽成形术(H-UPPP)改良为UY-UPPP,观察这种改良术式是否提高疗效和(或)减少术后并发症。方法对82例中重度阻塞型睡眠呼吸暂停综合征的患者分别行H-UPPP和UY-UPPP术,应用视觉模拟评分评估术后疼痛,应用Epiworth嗜睡量表和PSG评估术后疗效,以及观察术后并发症如出血、呼吸事件和鼻咽返流等的发生。结果 UY-UPPP术式的患者术后第3和5天的疼痛模拟视觉评分疼痛的缓解显著较H-UPPP快,且获得了相似的疗效,而且减少了术后出血的发生。尽管术后短期内鼻咽返流较H-UPPP增高,但是术后半年则两者差异无显著性。结论 UY-UPPP能提高患者术后疼痛的缓解速度,减少术后出血的发生,且获得了与H-UPPP相似的手术效果。

[Objective ] To examine whether the revised H-UPPP （as UY-UPPP） would increase the curative effect and （or） reduced the complications compared to H-UPPP. [Methods] Eighty-two patients who suffered OSAHS were treated by H-UPPP and UY-UPPP respectively. Visual analogue scale, Epworth sleepiness scale, polysomnography before and after operation was used to evaluate the curative effect and complications of these two kinds of treatment. [ Results ] The postoperative pain of UY-UPPP was relieved more quickly and the postoperative bleeding was less than those of H-UPPP. The curative effect was similar to that of H-UPPP. The possibility Of pharyngonasal reflux of UY-UPPP was higher than that of H-UPPP in early phage, but wasn＇t statistically different after 6 months. [ Conclusion ] The revised H-UPPP （as UY-UPPP） relieves postoperative pain more quickly and decreases the possibility of bleeding compared with H-UPPP.