阻塞性睡眠呼吸暂停低通气综合征的腭咽成形术与等离子联合消融手术

Treating obstructive sleep apnea with nasal operation and plasma ablation surgery

目的探讨悬雍垂腭咽成形术(UPPP)+等离子联合消融手术治疗阻塞性呼吸暂停低通气综合征(OSAHS)临床效果。方法符合多导睡眠监测(PSG)标准的,并对一般治疗和正压通气治疗疗效欠佳的阻塞性呼吸暂停低通气综合征(OSAHS)患者,用悬雍垂腭咽成形术,保留悬雍垂,用等离子联合消融术。结果 22例治疗效果满意,2例双侧下鼻甲骨增生肥大,行二次下鼻甲骨部分取出术获治愈,1例鼻中隔偏曲患者行鼻中隔矫正术后获治愈。结论悬雍垂腭咽成形术(UPPP)+等离子联合消融手术治疗阻塞性呼吸暂停低通气综合征(OSAHS),疗效较满意。该治疗方式沿用了UPPP教科书式的手术方式外,大胆保留了过长悬雍垂,对鼻咽部软组织做了极限提高,改善了通气量,目前患者随访一年没有出现阻塞性呼吸暂停低通气综合征(OSAHS)的临床症状,远期疗效有待观察。

Objective To discuss the clinical effects of H-uvulopalatopharyngoplasty （UPPP） combined with Plasma ablation surgery to cure obstructive sleep apnea （OSAHS）. Methods patients who Complied with the PSG standard, and had poor efficacy on the general treatment and positive pressure ventilation were chosen, UPPP therapy was used, the Uvula of all patients were retained, and Plasma ablation surgery was adopted. Results 22 cases had good therapeutic effect among all cases. 2 case had Bilateral inferior turbinate hypertrophy and had been carried out the second Removal of inferior nasal concha partial, the cure was obtained. 1 case got nasal septum deviation, and after surgery, the patients was cured too. Conclusion Treatment effect of UPPP combined with Plasma ablation surgery to treat OSAHS is good. It is done as the UPPP standard operation mode, but long Uvula was retained in the protocal, which makes elevation at soft tissue of the nose pharynx, and Improves nasal ventilation. At present, patients were followed up for one year without clinical symptoms of OSAHS. Long term curative effect remains to be observed.