阻塞性睡眠呼吸暂停综合征患者手术前后腭咽测量及临床意义

Palatopharyngeal measurement of the patients with obstructive sleep apnea syndrome and its significance

目的 :为阻塞性睡眠呼吸暂停综合征 (OSAS)患者的病源定位 ,悬雍垂腭咽成形术 (UPPP)手术范围的确定和术后疗效的评定提供依据。方法 :对 2 0例正常人及 45例OSAS患者UPPP术前、术后腭咽部进行解剖测量并将相关数据进行对照分析。结果 :正常人和OSAS患者所测腭咽解剖指标分别为 :软腭长 (2 7.6 8± 7.17)mm ,(2 9.94± 4.71)mm(P <0 .0 5 ) ;悬壅垂宽 (8.40± 1.18)mm ,(10 .74± 1.6 8)mm(P <0 .0 1) ;悬雍垂长 (10 .2 0± 2 .85 )mm ,(11.94± 2 .48)mm(P <0 .0 1) ;咽侧距 (2 3 .70± 7.0 5 )mm ,(19.87± 4.40 )mm(P <0 .0 5 ) ;腭咽距 (12 .36± 3 .97)mm ,(9.80± 2 .90 )mm(P <0 .0 1) ,均存在显著差异。UPPP参照正常人腭咽指标保留软腭长度获得良好的手术效果 ,同时控制了并发症的发生。结论 :腭咽测量法简便实用 ,病源定位准确 ,使手术选择和切除范围更为合理 ,有助于提高疗效。

Objective:To determine pathological position of obstructive sleep apnea syndrome and provide anatomical data for uvalopalatopharyngoplasty(uppp) and valuing postoperative effect.Methods:Palatopharyngeal data in 20 normal adults and 45 patients with OSAS were measured and compared.Results:Palatopharyngeal data of normal adults and patients with OSAS are as followed,length of softpalate:27.68±7.17 mm,29.94±4.71 mm( P <0.05);width of uvula:8.40±1.18 mm, 10.74±1.68 mm( p <0.01);length of uvula:10.20±2.85 mm,11.94±2.84 mm ( P <0.01);distance of pharyx:23.70±7.05 mm,19.87±4.40 mm( P <0.05);distance of palatopharyx:12.36±3.97 mm,9.80±2.90 mm( P <0.01).All of which were significantly different.According to normal palatopharyngeal data,retaining softpalate of patients with OSAS in uppp had got good operative effects and decreased postoperative complication.Conclusion:Palatopharyngeal measurement is simple and appliable to determining pathological position of patients with OSAS,and is helpful to select operative methods,define the range operative excision and value postoperative effect.