经口腔黏膜入路舌悬吊术的可行性及疗效观察

Feasibility and efficacy of tongue suspension via oral mucous membranes approach

目的 探讨经口腔黏膜入路舌悬吊术治疗阻塞性睡眠呼吸暂停低通气综合征(OSAHS)的可行性及优势。方法 收录中南大学湘雅二医院2018年6月~2019年6月,经整夜多道睡眠图(PSG)监测诊断且Fujita分级为Ⅱ级的OSAHS患者46例,分为两组:口腔黏膜入路组(20例)行悬雍垂腭咽成形术(UPPP)+口腔黏膜入路舌悬吊术,颏下入路组(26例)行UPPP+颏下入路舌悬吊术。比较两组患者在手术操作时间、引流量、术后住院时间、术后并发症和疼痛评分方面的差异。术后6个月复查,PSG监测对比手术疗效,并对患者进行伤口瘢痕评分、外观满意度评分对比术后切口外观。结果 在手术操作时间、引流量、术后住院时间、并发症、疼痛评分两组差异均无统计学意义(P>0.05)。术后6个月复查PSG监测,两组患者呼吸暂停低通气指数(AHI)、血氧饱和度<90%时间占监测总时间的百分比(the percent of the total record time spent below 90% oxygen saturation,TS90%)和最低血氧饱和度(LSaO)差异均无统计学意义(P>0.05)。在术后瘢痕评分方面,口腔黏膜入路组明显优于颏下入路组(P<0.01)。结论 口腔黏膜入路舌悬吊术在不延长患者的治疗时间、不增加手术并发症的基础上,可以达到较好的美容效果,满足患者对术后美观的期望,值得临床推广和应用。

OBJECTIVE To explore the feasibility and advantages of tongue suspension via oral mucous membranes approach.METHODS From June 2018 to June 2019,46 Fujita grade Ⅱ OSAHS patients were included in the Xiangya Second Hospital.They were divided into two groups:oral mucous membranes approach group(20 cases were subjected to UPPP+ tongue suspension via oral mucous membranes approach) and submental approach group(26 cases were subjected to UPPP+ tongue suspension via submental approach).The differences in operation time,drainage volume,postoperative hospital stay,postoperative complications,pain score,wound scar score,and appearance satisfaction score were compared between the two groups during perioperative period.Six months after operation,PSG was operated to compared the surgical efficacy,and wound scar score and appearance satisfaction score.RESULTS There were no statistically differences between the two groups in operation time,drainage volume,postoperative hospital stay,complications,pain score,postoperative AHI,TS90% and minimum oxygen saturation(P>0.05).In terms of postoperative scar score and appearance satisfaction score,oral mucous membranes approach group was significantly better than submental approach group(P<0.01).CONCLUSION Without prolonging the surgical time and increasing the surgical complications,the oral mucous membranes approach tongue suspension can achieve a better aesthetic effect and meet the patients’ expectation of postoperative beauty,which is worthy of clinical promotion and application.