鼻外科手术联合上气道射频消融术用于阻塞性睡眠呼吸暂停低通气综合征伴慢性鼻塞患者治疗的疗效分析

Efficacy of surgical operation combined with nasal airway radiofrequency ablation in the treatment of light-moderate obstructive sleep apnea hypopnea syndrome complicated with chronic nasal obstruction

目的:对鼻外科手术联合上气道射频消融术用于伴慢性鼻塞的轻、中度阻塞性睡眠呼吸暂停低通气综合征治疗中的疗效、安全性及治疗依从性等进行研究,证实该疗法的临床价值。方法:选取2012年3月至2013年3月间治疗的轻、中度阻塞性睡眠呼吸暂停低通气综合征患者76例为研究对象,采用随机抽签的方式将其分为观察和对照组,每组38例。观察组研究对象采用鼻外科手术联合上气道射频消融术予以治疗;对照组采取常规的外科手术治疗。对治疗前后研究对象的嗜睡、鼾声、血氧饱和度等数据的变化进行比较及组间比较,就手术疗效、并发症发生率及治疗依从性等数据进行组间比较及统计学分析。结果:在嗜睡、鼾声和血氧饱和度的比较中,治疗前2组间无统计学差异(嗜睡评分P=0.062、鼾声评分P=0.058、血氧饱和度P=0.052);治疗后较治疗前2组研究对象均有有明显好转,具有统计学差异(嗜睡评分P=0.042、鼾声评分P=0.044、血氧饱和度P=0.040);在临床疗效的比较中,观察组总有效率(78.9%)高于对照组(57.9%),具有统计学差异(P=0.028);在并发症发生率及治疗依从性及复发率的比较中,观察组的并发症发生率、治疗依从率及复发率分别为21.1%、92.1%和15.8%均优于对照组(44.7%、78.9%、36.8%),具有统计学差异(并发症发生率P=0.028、治疗依从性P=0.035、复发率P=0.032)。结论:鼻外科手术联合上气道射频消融术用于伴慢性鼻塞的轻、中度阻塞性睡眠呼吸暂停低通气综合征治疗中具有症状改善快,疗效显著、安全性和治疗依从性高等优势,具有显著的临床价值。

Objective：to study the efficacy,safety and compliance of surgical operation combined with nasal airway radiofrequency ablation in the treatment of light-moderate obstructive sleep apnea hypopnea syndrome complicated with chronic nasal obstruction and to confirm the clinical value of the treatment. Methods：Seventeen-six patients with light-moderate obstructive sleep apnea hypopnea syndrome from March 2012 to March 2013 were enrolled as research objects and were randomly divided into observation group（n=38）and control group（n=38）. Patients in observation group were treated by nasal operation combined with upper airway radiofrequency ablation therapy while those in control group were treated by routine nasal operation. Drowsiness,snoring subjects,blood oxygen saturation and other comparative data were compared before and after the treatment. Data of curative effect,complication and compliance were statistically analyzed. Results：There was no significant difference between the two groups in sleepiness,snoring and oxygen saturation before the treatment（P=0.062,P=0.058,P=0.052）. After the treatment,symptoms of subjects were improved obviously,with significant differences（P=0.042,P=0.044,P=0.040）. Total effective rate of observation group was 78.9%,higher than that of 57.9% in control group,with significant differences（P=0.028）. The complication incidence,compliance rate and recurrence rate were 21.1%,92.1% and 15.8% in observation group,better than those of 44.7%,78.9%,36.8% in control group,with significant differences（P=0.028,P=0.035,P=0.032）. Conclusion：Surgical operation combined with nasal airway radiofrequency ablation is effective and safe in the treatment of light-moderate obstructive sleep apnea hypopnea syndrome complicated with chronic nasal obstruction,therefore have remarkable clinical value.