低温等离子射频辅助改良腭咽成形联合舌减容、鼻腔扩容术治疗中重度OSAHS

Observation on the therapeutic effect of modified uvulopalatopharyngoplasty combined tongue volume reduction with selective nasal cavity dilatation assisted by low-temperature plasma ablation on moderately severe degrees of OSAHS

目的观察低温等离子射频消融辅助改良腭咽成形术(UPPP)联合舌减容-选择性鼻腔扩容术治疗中重度阻塞性睡眠呼吸暂停低通气综合征(OSAHS)的疗效。方法回顾性分析我科2014年6月-2016年12月收治的164例中重度OSAHS患者,按手术方式分为观察组和对照组,每组82例。观察组实施低温等离子射频消融辅助改良UPPP联合舌体、舌根减容加选择性鼻腔扩容术,对照组仅行改良腭咽成形手术。术后随访6个月,比较两组近期疗效、病变复发率及手术并发症发生率。结果随访结束时,观察组和对照组的总有效率分别为84.14%和64.63%,差异有统计学意义(P<0.05);观察组的并发症发生率明显低于对照组。结论低温等离子射频消融辅助改良UPPP联合舌减容、选择性鼻腔扩容术对多平面阻塞造成的的中重度OSAHS近期效果较为满意,值得在临床推广应用。

Objective To investigate the therapeutic effect of modified uvulopalatopharyngoplasty（UPPP） combined tongue volume reduction with selective nasal cavity dilatation assisted by low-temperature plasma radiofrequency ablation on obstructive sleep apnea hypopnea syndrome（OSAHS） at moderately severe degrees based on a clinical trial. Methods A retrospective analysis was carried out among 164 patients with OSAHS at moderately severe degrees, treated in our Hospital from Jun., 2014 to Dec., 2016. These patients were divided into two groups according to the surgical procedures undergone by themselves, i.e. observation group（OG） and control group（CG）, with 82 cases each. The patients in OG accepted the surgical procedure combined modified UPPP with tongue root volume reduction and selective nasal cavity dilatation assisted by low-temperature plasma radiofrequency ablation, while those in CG only accepted the operation of routine modified UPPP. Then, all these cases were followed up for 6 months after the therapy to evaluate the short-term therapeutic effect, postoperative relapse rate of the condition and the occurring rate of complications associated with the surgery in a comparative way between the two groups. Result As evaluated by the end of follow-up period, the total effective rates were81.7% and 62.2% for OG and CG respectively, with obviously statistical significance（P〈0.05） between them. Moreover, the occurring rate of complications associated with the surgery was also significantly lower in the cases of OG than that of CG. Conclusion It can be concluded that the surgical procedures combined modified UPPP with tongue volume reduction and selective nasal cavity dilatation assisted by low-temperature plasma radiofrequency ablation hold satisfactory therapeutic effect on OSAHS patients at moderately severe degrees. Therefore, it is valuable to promote such a kind of comprehensive surgical procedure into clinical practice in a much wider range.