低温等离子辅助改良悬雍垂腭咽成形术联合鼻腔扩容和舌减容治疗中重度OSAHS的临床疗效分析

Clinical analysis of low-temperature plasma-assisted improved uvulopalatopharyngoplasty combined with nasal cavity expansion and tongue volume reduction for moderate to severe OSAHS

目的探讨低温等离子辅助改良悬雍垂腭咽成形术(uvulopalatopharyngoplasty, UPPP)联合鼻腔扩容和舌减容治疗中重度阻塞性睡眠呼吸暂停低通气综合征(obstructive sleep apnea hypopnea syndrome, OSAHS)的临床疗效。方法选取2015年9月至2018年4月单县海吉亚医院收治的180例中重度OSAHS患者,随机分为观察组和对照组,每组90例。对照组采用常规UPPP进行治疗,观察组采用低温等离子辅助改良UPPP、鼻腔扩容以及舌减容术进行治疗。术后6个月对比两组治疗的有效性及安全性。结果治疗6个月后,观察组的总有效率为80.00%,显著高于对照组的63.33%(χ^2=4.739,P=0.029),呼吸暂停低通气指数(apnea hypopnea index, AHI)更低,最低SpO2水平更高,复发率和并发症发生率(10.00%,10.00%)较对照组(21.11%,34.44%)更低,差异均有统计学意义(χ^2=4.229、15.557,P均<0.05)。结论低温等离子辅助改良UPPP术联合鼻腔扩容和舌减容治疗术能有效提高临床疗效,改善患者的最低血氧饱和度和AHI,安全性高,复发风险低,值得临床推广应用。

Objective To investigate the clinical efficacy of low-temperature plasma-assisted improved uvulopalatopharyngoplasty(UPPP) combined with nasal dilatation and tongue volume reduction in the treatment of moderate obstructive sleep apnea hypopnea syndrome(OSAHS). Methods One hundred and eighty patients with moderate and severe OSAHS from September, 2015 to April, 2018 were randomly divided into observation group and control group, with 90 patients in each group. Patients in the control group were treated with conventional UPPP, while patients in the observation group were treated with improved UPPP assisted by low-temperature plasma, nasal dilatation and tongue volume reduction. Six months after surgery, the efficacy and safety of the two groups were compared. Results After treatment, the total effective rate in the observation group was significantly higher than that in the control group(80.00% vs. 63.33%, χ^2= 4.739, P < 0.05). After surgery, compared with the control group, the patients in the observation group had lower AHI [(6.09±4.87)times/h vs.(8.48±5.32)times/h, t =-3.144, P < 0.05] and higher minimum oxygen saturation levels [(91.29 ± 5.93)% vs.(86.47 ± 4.35)%, t =6.218, P < 0.05], and lower incidence of complications(10.00% vs. 21.11%, χ^2= 4.229, P < 0.05) and recurrence rate(10.00%vs. 34.44%, χ^2= 15.557, P < 0.05). Conclusions Low temperature plasma assisted modified UPPP combined with nasal cavity dilation and tongue volume reduction can effectively improve the clinical efficacy, improve the patients’ minimum oxygen saturation and AHI, with high safety and low risk of recurrence, which is worthy of clinical application.