鼻腔扩容术治疗阻塞性睡眠呼吸暂停低通气综合征手术疗效研究

Efficacy of nasal cavity expansion surgery on obstructive sleep apnea hypopnea syndrome surgery efficacy research

目的探讨鼻腔扩容术对阻塞性睡眠呼吸暂停低通气综合征(obstructive sleep apnea hypopnea syndrome,OSAHS)患者主、客观指标影响,评价鼻腔扩容术的手术疗效。方法利用前瞻性对照研究方法,选取轻、中度OSAHS患者50例,在治疗前,术后3、6、12个月分别进行临床主、客观检测,观察鼻腔扩容术的疗效及术后鼻腔恢复情况。结果术后3、6、12个月手术总有效率分别为96%、94%、90%;呼吸暂停低通气指数、最低动脉血氧饱和度、视觉模拟量表(visual analogue scale,VAS)评分,鼻内镜Lund-Kennedy评分,术后3、6、12个月与术前比较,差异有统计学意义(tLSaO2=5.77、8.09、8.18,P均<0.01;tAHI=-7.50、-10.22、-10.27,P均<0.01;tVAS=2.34、2.48、1.64,P均<0.01;tLund-Kennedy=1.12、2.54、2.60,P均<0.01);术后6个月与术后12个月比较,差异无统计学意义(tLSaO2=0.09,P>0.05;tAHI=-0.04,P>0.05;tVAS=0.14,P>0.05;tLund-Kennedy=0.06,P>0.05)。结论鼻腔扩容术在治疗阻塞平面主要在鼻腔的OSAHS患者,疗效显著。术后3~6个月,鼻腔明显恢复期。术后6~12个月,鼻腔恢复缓慢。

OBJECTIVE To discuss the effect of the nasal cavity expansion technique in patients with obstructive sleep apnea hypopnea syndrome(OSAHS). METHODS With prospective control study, 50 cases were selected, including mild and moderate OSAHS patients. The clinical subjective and objective indicators were collected before treatment, postoperative 3, 6, 12 months. RESULTS The total effective rates of patients after surgery were 96%(3 months), 94%(6 months), and 90%(12 months). Compared with indexes before operation, the apnea hypopnea index(AHI),lowest artery oxygen saturation(LaSaO2), visual analogue scale(VAS), and nasal endoscopic grading based on the Lund-Kennedy score after surgery was all significantly different(tLSaO2 =5.77, 8.09, 8.18, P<0.01; tAHI =-7.50,-10.22,-10.27, P<0.01; tVAS =2.34, 2.48, 1.64, P<0.01; tLund-Kennedy =1.12, 2.54, 2.60, P<0.01). But, between the indexes of 6 months and 1 year after operation, the difference was not statistically significant(tLSaO2 =0.09, P>0.05; tAHI =-0.04, P>0.05; tVAS =0.14, P>0.05; tLund-Kennedy =0.06, P>0.05). CONCLUSION Nasal cavity expansion tech n iques had remarkable effect i n the t reat ment of patients with OSA HS whose block i ng planes were mainly in the nasal cavity. From 3 months to 6 months postoperatively, the recovery of nasal cavity was obvious. After 6 months to 1 year, nasal recovery was slow.