Apneagraph睡眠呼吸监测阻塞定位仪指导OSAHS手术治疗及在术后疗效评价中的作用

Significance of AG in OSAHS operation treatment guidance and evaluation of postoperative efficacy

目的:研究Apneagraph睡眠呼吸监测阻塞定位仪(AG)在指导阻塞性睡眠呼吸暂停低通气综合征(OSAHS)手术范围确定术式及评价术后疗效中的作用。方法:随机选择中国医科大学附属第一医院应用改良UPPP手术治疗的OSAHS患者56例,术前及术后6个月应用AG和PSG进行诊断及疗效评价,并采用嗜睡程度评估量表(ESS)评价嗜睡状态,术后6个月与术前ESS评分应用t检验进行统计对比分析,用SPSS19.0软件进行数据分析。结果:术后6个月手术疗效评估显效42例(75%),有效14例(25%),未愈0例。AHI下降比例与腭后区构成比成正相关(r=0.667)。腭后区构成比≥73.5%者38例,显效34例(89.47%),有效4例(10.53%),未愈0例。结论:AG具有分析睡眠相关呼吸紊乱事件和判定上气道阻塞平面的双重功能,AG对改良UPPP术后疗效的评估具有重大的客观临床指导意义;应用改良UPPP治疗OSAHS可提高手术疗效;推荐当OSAHS患者腭后区构成比≥73.5%,无需对舌后区进行手术治疗。

Objective： Apneagraph can be used to discuss which the best operation scheme is for OSAHS. Effects of uvulopalatopharyngoplasty can be assessed by Apneagraph in obstructive sleep apnea hypopnea syn- drome （OSAHS） patients. Method： Fifty-six patients with OSAHS received the modified UPPP operation were randomly selected in our hospital. The AG and PSG were applied for diagnosis and evaluation of operation effects. The sleepiness state was assessed by ESS（Epworth sleepiness scale） 6 months after the surgery, compared with the preoperative ESS scores using attest for statistical analysis. We used the SPSS19.0 software to carry our data analysis. Result：After 6 months, the evaluation of postoperative efficacy came out to be completely controlled in 42 cases（75% ）, significantly effective in 14 cases（ 25 %）, and uncured in 0 cases. Correlation between the transpala- tal obstruction proportion and the AHI reduction percentage was significantly positive（r= 0. 667）. There were 38 patients with oropharynx obstruction percentage more than 73.5 %, presented completely controlled in 34 cases （89.47%）, significantly effective in 4 cases（10.53%） ,and uncured in 0 cases. Conclusion： AG has the dual func- tions of analyzing sleep-related respiratory disturbance events and determining upper airway obstruction sites. AG application in the postoperative evaluation of modified uppp has significantly objective guide significance. The mod- ified UPPP for treatment of OSAHS can improve the operation effect. Patients with oropharynx obstruction per- centage more than 73.5% don＇t need to receive the operation for treatment of retroglottal region.