Repose舌骨舌根悬吊联合腭咽成形术治疗重度阻塞性睡眠呼吸暂停低通气综合征

Hyoid and tongue base suspension with Repose system combined with UPPP for patients with severe obstructive sleep apnea hypopnea syndrome

目的探讨Repose舌骨舌根悬吊术联合腭咽成形术(UPPP)治疗重度阻塞性睡眠呼吸暂停低通气综合征(OSAHS)的疗效。方法对28例重度OSAHS患者经鼻咽通气管、上气道CT、头颅定位侧位片、电子鼻咽喉镜结合Muller试验确定存在腭咽及舌咽平面阻塞。行R e p o s e系统舌骨和(或)舌根悬吊术+U P P P。结果术后随访6～12个月,复查上气道CT、多道睡眠图(PSG)监测,手术前后呼吸暂停低通气指数(AHI)及最低动脉血氧饱和度(lowest arterial oxygen saturation,LSaO2)的变化均有统计学意义(P均<0.05)。AHI从术前(56.32±15.70)次/h下降至术后(18.67±8.56)次/h,LSaO2从术前(56.37±4.35)%上升至术后(86.03±11.24)%。按杭州会议标准,治愈6例,显效18例,无效4例,总有效率为85.7%。术后除1例发生大出血外,未见其他严重并发症。结论同时存在腭咽及舌咽平面阻塞的重度OSAHS患者,Repose系统舌骨和(或)舌根悬吊术联合UPPP是目前一种有效的外科手术方案。

OBJECTIVE To study the efficacy of hyoid and tongue base suspension with Repose system combined with UPPP for patients with severe obstructive sleep apnea hypopnea syndrome（OSAHS）.METHODS Twenty eight patients with severe OSAHS were diagnosed as the obstructive level in the velopharyngeal and glossopharyngeal area.The patients underwent hyoid and tongue base suspension with Repose system and UPPP.RESULTS The follow-up was 6 to 12 months after operation.The AHI decreased from 56.32±15.70 before operation to 18.67±8.56 after operation and t h e L S a O2 i n c r e a s e d f r o m（5 6.3 7 ± 4.3 5） % t o（86.03±11.24）%.According to the Hangzhou Conference Standard,6 cases were cured,18 cases were improved and 4 cases were ineffective,the total efficacy rate was 85.7%.No severe complications were found except one with bleeding after operation.CONCLUSION The hyoid and tongue base suspension with Repose system combined with UPPP is an effective method for severe OSAHS patients with obstructive level in the velopharyngeal and glossopharyngeal area.