手术治疗OSA合并咽喉反流患者的疗效分析

The surgical effect on obstructive sleep apnea with laryngopharyngeal reflux

目的:探讨手术治疗OSA合并咽喉反流(LPR)患者的疗效。方法:回顾性分析42例诊断为中重度OSA合并LPR,行低温等离子辅助下改良悬雍垂腭咽成形术治疗的患者,比较患者术前、术后的PSG结果、反流症状指数量表(RSI)评分和反流体征量表评分(RFS)、24 h食管pH值监测结果。结果:患者术后AHI比术前明显降低(P<0.05),平均血氧饱和度和最低血氧饱和度均升高(P<0.05)。术后RSI和RFS评分总分低于术前(P<0.05)。术后24 h食管内pH<4.0的时间占总时间的百分率低于术前(P<0.05)。结论:对于口咽部阻塞为主的中、重度OSA合并LPR患者,手术治疗不仅可以减轻气道狭窄阻塞,还可以改善LPR症状和体征。

Objective:To explore the effect of surgical treatment for OSA with laryngopharyngeal reflux(LPR).Method:A retrospective analysis was made in 42 patients diagnosed as moderate to severe OSA with LPR and treated with modified-coblation assisted Uvulopalatopharyngoplasty(M-CAUP).The results of PSG,reflux symptom index(RSI),reflux finding score(RFS)and 24-hour esophageal pH monitoring before and after operation were compared.Result:The AHI after operation was significantly lower than that before operation(P<0.05),and the average oxygen saturation and minimum blood pressure saturation were increased(P<0.05).The total scores of RSI and RFS after operation were lower than those before operation(P<0.05).The percentage of time of pH<4.0 in esophagus 24 hours after operation was lower than that before operation(P<0.05).Conclusion:For patients with moderate to severe OSA combined with LPR with oropharyngeal obstruction,surgical treatment can not only reduce airway stenosis and obstruction,but also improve the symptoms and signs of LPR.