改良Z形腭咽成形术治疗阻塞性睡眠呼吸暂停低通气综合征的疗效分析

Effect of modified Z shape palatopharyngoplasty in the treatment of obstructive sleep apnea hypopnea syndrome

目的：分析改良Z形腭咽成形术对阻塞性睡眠呼吸暂停低通气综合征（ OSAHS）的临床疗效。方法：选取71例OSAHS患者，采取改良Z形腭咽成形术治疗，观察患者治疗前后各项参数变化及疗效。结果：术后BMI、AHI、鼾声响度评分、CT90及Epworth嗜睡量表评分较手术前显著下降（P〈0.01），最低动脉血氧饱和度较手术前显著上升（P〈0.01）；术后共出现创面水肿1例，呼吸道堵塞1例，鼻咽闭合不良1例，发生率4.23%，均经对症治疗后于2~4 d内缓解；71例均获得有效随访，平均随访时间（11.0±1.3）个月，疗效分析显示治愈49例，显效6例，有效7例，总有效率87.3%。结论：改良Z形腭咽成形术可有效改善OSAHS患者血氧饱和度，扩大腭咽腔通气面积，从而保证其临床疗效，同时，该术式可保证咽黏膜的正常生理状态，降低不良反应发生率，安全性良好，值得临床广泛推广。

Objective：To analyze the effects of modified Z shape palatopharyngoplasty in the treatment of obstructive sleep apnea hypopnea syndrome（ OSAHS） . Methods：Seventy-one patients with OSAHS were treated with modified Z shape palatopharyngoplasty. The clinical parameters before and after treatment and effects in all patients were observed. Results：Compared with before operation,the BMI,AHI,snoring loudness score,CT90 and ESS score in patients decreased significantly after operation（P〈0. 01）,but for LSaO2,it significantly increased（P〈0. 01）. Postoperative wound edema in 1 case,respiratory tract obstruction in 1 case and nasopharyngeal closure bad in 1 case were found,the incidence of which was 4. 23%,and the patients alleviated in 2 to 4 days after treatment. The average following up time of all patients was（11 ± 1. 3） months. Forty-nine cases were cured,6 cases were excellent and 7 cases were effective,the total efficiency of which was 87. 3%. Conclusions：The improved Z shape palatopharyngoplasty can effectively improve blood oxygen saturation,expand the velopharyngeal cavity ventilation area,keep the normal physiological state of pharynx mucosa and reduce the incidence of adverse reaction,which is worthy of clinical popularization.