UPPP治疗阻塞性睡眠呼吸暂停低通气综合征的远期疗效

Long-term result of uvulopalalophanyngoplasty for obstructive sleep apnea hypopnea syndrome

目的 :探讨悬雍垂腭咽成形术 (uvulopalalophanyngoplasty ,UPPP)治疗阻塞性睡眠呼吸暂停低通气综合征 (obstructivesleepapnea -hypopneasyndrome ,OSAHS)的远期疗效。方法 :38例经多导睡眠图 (polysomnogra phy ,PSG)确诊为OSAHS ,根据呼吸紊乱指数 (apneaandhypopeaindex ,AHI)和睡眠中的最低血氧饱和度 (SaO2 )将患者分为轻中度组和重度组 ,患者均用UPPP治疗 ,术后随访 1年以上 ,并于术后 1年再行PSG监测 ,计算术后 1年AHI和最低SaO2 的缓解率 ,按照缓解率判定手术疗效。结果 :1.患者术后 1年的AHI明显低于术前 (P <0 .0 0 1) ,最低SaO2 明显高于术前 (P <0 .0 0 1) ;2 .轻中度组AHI及最低SaO2 的术后缓解率明显高于重度组 (P <0 .0 1) ;3.轻中度组术后的治愈率、显效率明显高于重度组 ,无效率明显低于重度组(P <0 .0 1)。结论 :1.UPPP是临床治疗OSAHS的有效手段 ;2 .UPPP主要适用于轻度和中度的OSAHS患者 ,对重度OSAHS患者疗效欠佳。

Objective: To study the long-term result of uvulopalalophergngoplasty (UPPP) for obstructive sleep apnea hypopnea syndrome(OSAHS) . Methods: 38 patients who were diagnosed as OSAHS through polysomnography(PSG), were divided into low-moderate grade and heavy grade based on apnea and hypopea index (AHI) and minimum SaO 2. All the patients were undergone UPPP and were interviewed in more than one year, one year later they were performed the examination of PSG, then were worked out the alleviation rate of AHI and minimum SaO 2 compared with pre-operation and were judged surgery result (cule,availability,invalidity) according to the alleviation rate . Results:(1)AHI of one year after surgery was remarkably lower than that of preoperative (P<0.001). Minimum one after surgery SaO 2 was distinctly higher than that of preoperative(P<0.001);(2) Postoperative alleviation rates of AHI and minimum SaO 2 in low-moderate grade were prominently higher than those of heavy grade;(3) Postoperative cule and availability rate in low-moderate grade were notably higher than those of heavy grade,while invalidity was distinctly lower than that of heavy grade (P<0.01). Conclusion: (1) UPPP is a clinical efficient method for OSAHS;(2) UPPP is mainly suit for OSAHS patient of low and moderate grade and is inefficient for OSAHS patient of heavy grade.