等离子铺助下H-UPPP手术治疗重度阻塞性睡眠呼吸暂停低通气综合征

Plasma Spread under H-UPPP Surgery Treatment of Severe Obstructive Sleep Apnea Hypopnea Syndrome

目的：探讨低温等离子铺助下行H-UPPP手术,肥厚软腭、悬雍垂及腭咽肌射频消融治疗重度OSAHS的疗效。方法：回顾分析经PGS监测、阻塞平面在口咽部的60例重度OSAHS患者,用EIC5874刀头的融切功能行H-UPPP手术,对肥厚软腭、悬雍垂及腭咽肌用EIC4855刀头射频消融。结果：患者术后口咽腔左右、前后径扩大,咽腔结构、功能完整。术后6~12月随访并行PGS监测,AHI值下降、LSa O2升高差异有统计学意义（P〈0.01）。患者主观症状改善,有效率达到91.7%。结论：OSAHS的外科治疗方法多种多样,对于阻塞平面在口咽部的重度OSAHS患者,等离子铺助下H-UPPP手术,具有出血少、创伤小,又能保留咽腔结构及功能的有效治疗。

Objective： To study plasma assisting H-UPPP surgery under low temperature, and the therapeutic effect of RFCA of the hypertrophy of the soft palate, uvula and palatopharyngeal muscle treating severe OSAHS. Methods： Sixty cases of severe OSAHS with blocking plane in oropharynx under PGS monitoring were retrospectively analyzed. The melt-cut function of EIC5874 blade were applied to H-UPPP surgery, the thick soft palate, uvula and palatopharyngeal muscle were conducted RFCA with EIC4855 blade. Results： Postoperative patient＇s oropharyngeal cavity around, before and after were enlarged, the pharyngeal cavity structure, and function were complete. PGS monitoring were conducted to the postoperative 6 and 12 months follow-up, AHI values dropped, LSa02 had statistical significance （P〈0.01）. Patients with subjective symptoms were improved, effective rate reached 91.7%. Conclusion： The surgical treatment of OSAHS is varied. For patients with severe OSAHS with the blocking plane in the oropharynx, plasma assiting H- UPPP surgery under low temperature is distinguished by less bleeding, small trauma, and with the pharyngeal cavity structure and function preserved.