悬雍垂腭咽成形术联合低温等离子舌体消融术治疗重度OSAHS的疗效分析

Curative Effect Analysis of Uvulopalatopharyngoplasty Combined with Low TemperaturePlasma Tongue Ablation in the Treatment of Severe OSAHS

目的:分析悬雍垂腭咽成形术(UPPP)联合低温等离子舌体消融术治疗阻塞性睡眠呼吸暂停低通气综合征(OSAHS)的疗效。方法:选取2019年1月至2021年1月中国人民解放军新疆军区总医院收治的重度OSAHS患者102例作为研究对象,按照不同手术方式分为观察组和对照组,每组51例。观察组采用UPPP联合低温等离子舌体消融术治疗,对照组单独应用UPPP治疗,比较2组患者手术前后多导睡眠监护(PSG)监测指标、手术前后Epworth嗜睡量表(ESS)及视觉模拟评分法(VAS)评分,比较2组患者治疗效果,比较2组手术前后魁北克睡眠问卷(QSQ)评分,比较2组术后复发率及并发症情况。结果:术后1年观察组患者阻塞性睡眠呼吸暂停指数(AHI)和最低动脉血氧饱和度(LSaO2)改善程度相比于对照组均明显升高,差异均有统计学意义(均P<0.05)。术后6个月及术后1年2组患者的ESS评分及VAS评分均较术前明显改善,且组间比较差异均有统计学意义(均P<0.05),观察组明显优于对照组,差异均有统计学意义(均P<0.05)。观察组患者术后1年治疗有效率为88.24%,对照组为78.43%,差异有统计学意义(P<0.05),观察组术后复发率及并发症发生率明显低于对照组,差异均有统计学意义(均P<0.05),术前2组患者QSQ评分比较无明显差异,术后均较术前明显升高,且观察组术后QSQ评分明显高于对照组,差异均有统计学意义(均P<0.05)。结论:UPPP联合低温等离子舌体消融术治疗重度OSAHS疗效确切,不良反应少,值得推广应用。

Objective:Analyze the efficacy of uvulopalatopharyngoplasty(UPPP)combined with low-temperature plasma tongue ablation in the treatment of obstructive sleep apnea hypopnea syndrome(OSAHS).Methods:A total of 102 patients with severe OSAHS admitted to our hospital from 2019 to January 2021 were selected as the study subjects.They were divided into an observation group and a control group according to different surgical methods,with 51 cases in each group.The observation group was treated with UPPP combined with low-temperature plasma tongue ablation,while the control group was treated with UPPP alone.The preoperative and postoperative polysomnography(PSG)monitoring indicators,Epworth Sleepiness Scale(ESS),and Visual Analog Scale(VAS)scores were compared between the two groups of patients.The treatment effect was compared between the two groups of patients,and the Quebec Sleep Questionnaire(QSQ)scores before and after surgery were compared.The postoperative recurrence rate and complications were also compared between the two groups.Results:After 1 year of surgery,the improvement of obstructive sleep apnea index(AHI)and minimum arterial oxygen saturation(LSaO 2)in the observation group was significantly higher than that in the control group,and the difference was statistically significant(P s<0.05).The ESS and VAS scores of the two groups of patients at 6 months and 1 year after surgery were significantly improved compared to before surgery,and the differences between the groups were statistically significant(P s<0.05).The observation group was significantly better than the control group,and the differences were statistically significant(P s<0.05).The one-year postoperative treatment effectiveness rate of the observation group was 88.24%,while that of the control group was 78.43%,with a statistically significant difference(P<0.05).The postoperative recurrence rate and incidence of complications in the observation group were significantly lower than those in the control group,with a statistically significant difference(P s<0.05).There was no significant difference in QSQ scores between the two groups before surgery,and both groups showed a significant increase compared to before surgery.Moreover,the postoperative QSQ scores in the observation group were significantly higher than those in the control group,with a statistically significant difference(P s<0.05).Conclusion:The combination of UPPP and low-temperature plasma tongue ablation is effective in treating severe OSAHS with minimal adverse reactions,and is worthy of promotion and application.