改良腭咽成形术治疗成人OSAS的疗效及对血清炎性介质的影响

Treatment effect of Han-uvulopalatopharyngoplasty on adult OSAS patients and its influence in serum Inflammatory mediators

目的:探讨改良腭咽成形术(H-UPPP)治疗成人阻塞性睡眠呼吸暂停综合征(OSAS)疗效及对血清炎性介质的影响。方法:收集2014年6月~2016年7月间在本院接受住院治疗的OSAS患者118例,回顾性分析其接受的手术方式,分为接受雍垂额咽成形术(UPPP)治疗的对照组57例、接受H-UPPP治疗的观察组61例。对比两组患者的治疗效果、通气阻力及全身炎症状态的差异。结果:观察组患者的临床治疗有效率显著高于对照组患者(P<0.05)。术后1个月,两组患者的呼吸总阻抗(Zrs)、中心阻力(Rc)、总气道阻力(R5)、中心气道阻力(R20)水平均低于术前,且观察组患者Zrs、Rc、R5、R20水平降低程度大于对照组患者(P<0.05);术后12h,两组患者血清中促炎介质高敏C反应蛋白(hs-CRP)、白介素(IL)-1β、IL-6、IL-17、IL-23的含量均高于术前,而观察组患者血清中上述指标的含量上升程度低于对照组患者(P<0.05)。结论:H-UPPP用于成人OSAS治疗的效果优于UPPP,且该术式术后早期全身炎症程度较轻,在手术高效性及微创性方面均有优势。

Objective：Tostudyhetreatmenteffect of Han-uvulopalatopharyngoplasty on adult OSAS patients and its influence in serum Inflammatory mediators.Methods：118 cases of adult OSAS patients in our hospital during June 2014 to July 2016 were selected as research subject,surgery way was retrospectively analyzed and all patients were divided into control group（n=57）underwent UPPP,observation group（n=61）underwent H-UPPP.Comparison of treatment effect,ventilation resistance and systemic inflammatory state between two groups.Results：The clinical effective rate in observation group was significantly higher than that in control group（P〈0.05）.One month after surgery,Zrs,Rc,R5,R20 levels in two groups were lower than those before operation,and the decrease degree in observation group were greater than those in control group（P〈0.05）;12 h after surgery,serum contents of proinflammatory mediators such as hs-CRP,IL-1β,IL-6,IL-17,IL-23 in two groups were higher than before surgery,and the increase degree were lower than those in control group（P〈0.05）.Conclusion：H-UPPP is better than UPPP in the treatment of adult OSAS,and the early postoperative systemic inflammation degree is lighter,and it has the advantages in high efficiency and minimally invasive.