软腭折叠术联合舌根等离子消融治疗OSAHS的疗效分析

Analysis of the therapeutic effectiveness of the soft palate folding surgery combined with tongue base ablation for thetreatment of obstructive sleep apnea hypopnea syndrome

目的探讨分析软腭折叠术联合舌根等离子消融治疗阻塞性睡眠呼吸暂停低通气综合征(OSAHS)的疗效。方法选择2018年6月—2020年6月在本院确诊为腭咽区及舌咽狭窄的中重度OSAHS的患者66例作为研究对象,术前告知患者手术的疗效及相应的风险,由患者自愿选择入组,其中研究组(37例)行软腭折叠术联合舌根等离子消融术;对照组(29例)单纯行软腭折叠术,比较两组患者的术后疗效。结果两组患者术前各项数据比较差异无统计学意义(P>0.05);研究组术后总有效率为75.5%,明显高于对照组的51.7%,差异具有统计学意义(P<0.05);两组术后AHI、LSaO_(2)、ESS、口咽腔最小前后径与术前相应数据比较,差异均具有统计学意义(P<0.05);术后研究组与对照组比较在口咽腔最小前后径上差异有统计学意义(P<0.05),在AHI、LSaO_(2)及ESS上差异无统计学意义(P>0.05)。结论软腭折叠术联合舌根低温等离子消融术在阻塞平面为口咽和舌根的OSAHS患者中疗效确切,值得临床推广应用。

Objective To investigate the therapeutic effectiveness of the soft palate fold surgery combined with tongue base ablation for the treatment of obstructive sleep apnea hypopnea syndrome(OSAHS).Methods Sixty-six patients with moderate-severeOSAHS whose obstructive plane located in the oropharynx and tongue base were enrolled as study objects,and they were divided into two groups according to the patient's independent choice under the condition of fully informed the surgical efficacy and related risks before the operation.The 37 patients in the study groups received soft palate fold surgery combined with tongue base ablation,whilethe 29 patients in the control group received the soft palate fold surgery.Therapeutic effectiveness between the two groups was compared.Before and after operation,paired t test and chi-square test were used in the comparison between the two groups.Results There was no significant difference in preoperative data between the two groups.The total effective rate of the study experimental group was 75.5%after operationand significantly higher than 51.7%of the control group,the difference was statistically significant(P<0.05).There were statistically significant differences between the two groups in terms of the AHI,LSaO_(2),ESS and the minimum diameter of oropharyngeal cavity at before and after surgery(P<0.05).There was significant difference in the minimum diameter of oropharyngeal cavity between the study group and the control group after surgery(P<0.05).However,there was no significant difference in the AHI,LSaO_(2) and ESS between the study group and the control group after surgery(P>0.05).Conclusions Therapeutic effectiveness of the soft palate fold surgery combined with low-temperaturetongue base ablation is definitive and deserves further dissemination.