改良腭帆成形术治疗轻、中度阻塞性睡眠呼吸暂停低通气综合征疗效

Outcomes of modified velopharyngoplasty in treatment of mild and moderate OSAHS

目的探讨改良腭帆成形术(VPP)治疗轻、中度阻塞性睡眠呼吸暂停低通气综合征(OSAHS)的疗效。方法 32例腭咽平面狭窄、扁桃体占据气道<50%的轻、中度OSAHS患者,随机均分为两组:A组行改良腭咽成形术(H-UPPP);B组行VPP术。术前1d及术后6个月行多导睡眠检测(PSG),填写Epworth嗜睡量表(ESS)及鼾声视觉模拟评分(VAS)。结果两组术后睡眠呼吸暂停低通气指数(AHI)、最低血氧饱和度(LSaO2)、ESS评分及VAS评分均明显改善(P<0.05)。B组术后VAS评分较A组改善明显[(-4.38±0.46)分vs.(-3.63±1.02)分](P<0.05)。结论对腭咽平面狭窄且无扁桃体肥大的轻中度OSAHS患者行改良VPP术,在保证疗效的同时降低了患者术后鼾声。

Objective To investigate the efficacy of modified velopharyngoplasty（VPP） in the treatment of mild and moderate obstructive sleep apnea hypopnea syndrome （OSAHS）. Methods Thirty-two OSAHS patients with obstructive plane of the oropharynx but without toncil hypertrophy were equally randomized into two groups. The patients in group A received uvulopalatopharyngoplasty with uvulae preservation（H-UPPP） and those in group B received modified VPP with partial resection of the musculus vuvlare and preservation of the toncil. The outcomes were evaluated with polysomnography（PSG）, epworth sleepness scale（ESS） and visual analogue scale（VAS） of snore one day before operation and in the 6th month after operation. Results Compared to before, the apnea hypopnea index （AHI）, lowest SaO2 （LSaO2）, ESS and VAS score of snore after surgery were all improved significantly in both groups（P〈0. 05）. Postoperative VAS score of snore was reduced more in group B than that in group A[（-4.38± 0.46） points vs. （-3.63± 1.02） points] （P〈0. 05）. Conclusion Modified velopharyngoplasty with partial resection of the musculus uvulae and preservation of toncil is an effective surgical method for mild and moderate OSAHS patients whith obstructive plane in the oropharvnx but without hypertrophy of the toncil.