内镜辅助下骨螺钉系统与UPPP联合其他术式治疗中重度OSAHS的疗效

The efficacy of endoscopic assisted bone screw system and UPPP combined with other operations in treatment of moderate and severe OSAHS

目的:探讨内镜辅助下骨螺钉系统(Repose系统)舌骨悬吊术联合悬雍垂腭咽成形术(UPPP)+舌根射频消融术与悬雍垂腭咽成形术+舌根射频消融术治疗中重度阻塞性睡眠呼吸暂停低通气综合征(OSAHS)的疗效。方法:将60例中重度OSAHS患者简单随机化分成Repose系统组和舌根射频消融术组,经上气道阻塞定位系统、上气道CT、头颅定位侧位片、电子鼻咽喉镜检查,结合Muiller试验检查,确定存在腭咽及舌咽平面阻塞,分别行内镜辅助下Repose系统舌骨悬吊术联合UPPP+舌根射频消融术(30例)与UPPP+舌根射频消融术(30例)的患者于术前及术后6～12个月进行多导睡眠呼吸监测(PSG),比较2组患者的疗效。结果:对于中重度OSAHS患者内镜辅助下骨螺钉系统联合UPPP+舌根射频消融术疗效明显优于UPPP+舌根射频消融术。结论:舌骨悬吊术联合UPPP+舌根射频消融手术是目前治疗腭咽及舌咽平面阻塞的中重度患者的一种安全有效的手术方案。

[Objective] To explore the endoscopic assisted bone screw system （Repose system） of hyoid suspension plus uvu- lopalatopharyngoplasty （UPPP） plus tongue base radiofreqnency ablation with UPPP and tongue base radiofrequency ablation in treatment of moderate to severe obstructive sleep apnea hypopnea syndrome （OSAHS） effect. [ Melhod] 60 cases of severe OS- AHS patients in simple randomized into Repose group and the tongue base radiofrequency ablation group. The upper airway ob- structlon airway CT positioning system, lateral cephalograms, electron nasopharyngolarngoscopy, combined with Muillertest were carried out to determine the existence of pharyngeal plane blocking. Patients who were underwent endoscopic assistedhyoid suspension Repose operation system and UPPP ＋ tongue base radiofrequency ablation（ 30 cases） and UPPP ＋ tongue base ra- diofrequency ablation （30 cases） were monitored by polysomnography （PSG） in the preoperative and postoperative 6 - 12 months. The effects were compared between 2 groups of patients. [ Result ] the bone screw system combined with UPPP ＋ in- patients with severe OSAHS endoscope assisted tongue base radiofrequency ablationtherapy was better than UPPP ＋ tongue base radiofrequency ablation. [ Conclusion] Hyoid suspension plus UPPP ＋ tongue base radiofrequency ablation operation is a safe and effective operation scheme in treatment of pharyngeal plane blocking the moderate and severe patients.