改良悬雍垂腭咽成形术联合鼻部同期手术对重度阻塞性睡眠呼吸暂停低通气综合征的疗效分析

Efficacy of modified uvulopalatopharyngoplasty combined with simultaneous nasal surgery for severe obstructive sleep apnea hypopnea syndrome

目的:探讨改良悬雍垂腭咽成形术联合鼻部同期手术在治疗重度阻塞性睡眠呼吸暂停低通气综合征(OSAHS)的近期和远期效果。方法:根据治疗方式的不同,将30例重度OSAHS分为观察组(n=10)和对照组(n=20)。观察组应用改良悬雍垂腭咽成形术加鼻腔扩容术,对照组应用单纯腭咽成形术。观察患者术后半年、1年和2年的呼吸暂停低通气指数(AHI)、夜间最低动脉血氧饱和度(LSaO 2)、Epworth嗜睡量表(ESS)评分以及视觉模拟量表(VAS)。结果:术后半年、术后1年,两组患者AHI和LSaO 2比较,差异无统计学意义(P>0.05);术后2年,观察组AHI明显低于对照组[(21.40±10.15)次/h vs.(30.51±8.71)次/h],LSaO 2明显高于对照组[(80.05±8.56)%vs.(71.11±9.17)%],差异有统计学意义(P<0.05);术后半年、1年、2年,两组患者ESS评分和整体VAS评分比较,差异无统计学意义(P>0.05),观察组术后半年、1年、2年鼻塞VAS评分均低于对照组[(2.07±0.55)vs.(8.05±2.44),(3.37±1.72)vs.(7.74±2.55),(3.98±1.52)vs.(8.75±2.07)],差异有统计学意义(P<0.01);观察组总有效率为90%,高于对照组的75%,差异有统计学意义(P<0.05)。结论:改良悬雍垂腭咽成形术联合鼻部同期手术治疗重度OSAHS近期及远期效果均良好。

Objective:To investigate the short-term and long-term effects of modified uvulopalatopharyngoplasty combined with simultaneous nasal surgery in the treatment of severe obstructive sleep apnea hypopnea syndrome.Methods:30 patients with severe obstructive sleep apnea-hypopnea syndrome were divided into observation group(n=10)and control group(n=20).The observation group was treated with modified uvulopalatopharyngoplasty plus nasal dilatation,the control group was treated with palatopharyngoplasty alone.The AHI,LSao 2,Epworth sleepiness scale(ESS)and visual analogue scale(VAS)were measured half a year,1 year and 2 years after operation.Results:There were no significant difference in AHI and LSaO 2 between the two groups at half a year after operation and 1 year after operation(P>0.05),the AHI of the observation group was significantly lower than that of the control group[(21.40±10.15)times/h vs.(30.51±8.71)times/h],and the LSaO 2 of the observation group was significantly higher than that of the control group[(80.05±8.56)%vs.(71.11±9.17)%],the differences were statistically significant(P<0.05).There was no significant difference in ESS score and overall VAS score between the two groups half a year,1 year and 2 years after operation(P>0.05).The VAS score of nasal obstruction in the observation group was significantly lower than that in the control group[(2.07±0.55)vs.(8.05±2.44),(3.37±1.72)vs.(7.74±2.55),(3.98±1.52)vs.(8.75±2.07)],the differences were statistically significant(P<0.01).The total effective rate in the observation group was 90%,which was higher than 75%in the control group,the difference was statistically significant(P<0.05).Conclusion:Modified uvulopalatopharyngoplasty combined with simultaneous nasal surgery has good short-term and long-term results in the treatment of OSAHS.