改良缝合在等离子辅助下悬雍垂腭咽成形术中的临床应用

Clinical application of modified suture techniques in coblation assisted uvulopalatopharyngoplasty

目的探讨改良缝合在等离子辅助下悬雍垂腭咽成形术中的临床应用。方法选择我科2014年1月~2016年1月经手术治疗的阻塞性睡眠呼吸暂停低通气综合征(OSAHS)患者32例(中度5例,重度27例),阻塞平面均在口咽部,回顾性分析其临床资料及疗效。结果术前、术后Müller试验对比,术后咽腔明显扩大,30例患者术后10~12d伤口伪膜脱落并愈合,2例伤口部分裂开2周后愈合,主观症状明显改善,术后最低血氧饱和度(LSa O2)升高,呼吸暂停低通气指数(AHI)及Epworth嗜睡量表(ESS)评分下降,差异均有统计学意义(P<0.01),总有效率为84.4%。结论改良缝合用于等离子辅助下悬雍垂腭咽成形术能有效解除口咽部阻塞,疗效显著,同时对防止伤口裂开、术后出血及鼻咽返流有重要意义。

Objective To explore the clinical application of modified suture techniques in coblation assisted uvulopalatopharyngoplasty（CAUP）.Methods A total of 32 patients with obstructive sleep apnea hypopnea syndrome determined the sites of airway obstruction at isolated retropalatal region underwent modified CAUP.Evaluated the clinical efficacy of modified CAUP,measured apnea-hypopnea index,the lowest oxygen saturation,oropharynx left-right diameter and anteroposterior diameter at retropalatal region before and after operation.Results Subjective symptoms were improved significantly,and the wound pseudo membrane began peeling and healing postoperative ten to twelve days after operation in 30 patients and 2 patients were partially splited and healing after 2 weeks.The diameter and cross-sectional area at retropalatal region measured by Müller＇s maneuver,AHI,the lowest oxygen saturation and ESS scores between before and after operation were significantly different（P〈0.01）.The total effective rate was 84.4%.Conclusion The modified CAUP can effectively remove obstruction at isolated retropalatal region with good curative effect.It has important significance in the prevention of wound dehiscence,bleeding and nasal regurgitation.