舌根悬吊治疗伴有舌后坠阻塞性睡眠呼吸暂停低通气综合征的疗效观察

Treatment of obstructive sleep apnea hypopnea syndrome caused by glossoptosis with tongue-base suspension

目的：评估悬雍垂腭咽成形术（ UPPP）联合Reposes系统舌根悬吊治疗伴有舌后坠阻塞性睡眠呼吸暂停低通气综合征（ OSAHS）的可行性和临床效果。方法回顾分析本科2010年7月～2012年12月行UPPP联合 Reposes 系统舌根悬吊治疗的14例伴有舌后坠 OSAHS 患者的临床资料。结果治愈3例（21．4％）、显效10例（71．4％）、有效1例（7．1％）。术前平均呼吸暂停低通气指数（ AHI）为50．7±19．4，术后平均AHI 为8．1±4．5（P＜0．05）；术前平均最低血氧饱和度（LSaO2）为66．6％±7．7％，术后平均LSaO2为78．6％±7．4％（P＜0．05）；术前Epworth 嗜睡量表（ESS）平均评分为（16．9±1．8）分，术后ESS平均评分为（8．3±2．4）（P＜0．05），差异均有统计学意义。主观症状均明显改善，术后1个月随访，未出现反流、吞咽及说话困难。结论 UPPP联合Reposes系统舌根悬吊治疗后，患者AHI、LSaO2及ESS指标均改善明显，该联合术式可作为治疗伴有舌后坠OSAHS的一个选择。（中国眼耳鼻喉科杂志，2015，15：13-15）

Objective To evaluate the safety and efficacy of uvulopalatopharyngoplasty （ UPPP） combined with Repose system tongue-base suspension for obstructive sleep apnea hypopnea syndrome （ OSAHS） caused by glossoptosis . Methods Data of 14 of OSAHS patients caused by glossoptosis with UPPP combined with Repose System tongue -base suspension from July 2010 to December 2012 were analyzed retrospectively .Results UPPP combined with Repose system tongue-base suspension improved sleep and daytime symptoms related to OSAHS .After at least 6 months of follow-up,3 patients were cured（21.4%）,10 persons improved markedly （71.4%）,1 patient was effective （7.1%） and no patients were invalid.The average apnea-hypopnea index （AHI） decreased from 50.7 ±19.4 to 8.1 ±4.5 （P〈0.05）;The mean of （LSaO2） increased from 66.6%±7.7%to 78.6%±7.4%（P〈0.05） and the average Epworth sleepiness scale scores decreased from 16.9 ±1.8 to 8.3 ±2.4 （P〈0.05）,respectively.Also,there was significant improvement in snoring,daytime sleepiness,and overall impact of the disease on quality of life .All patients returned to normal subjective swallowing and speaking function in the follow-up one month after the surgeries .Conclusions AHI, LSaO2 and ESS significantly improved in OSAHS patients treated with UPPP combined with Repose system tongue-base suspension .The surgery is a valid option for OSAHS patients caused by glossoptosis .