悬雍垂腭咽成形术320例疗效分析

Clinical analysis of 320 cases of uvulopalatopharyngoplasty

目的 本文观察阻塞性睡眠呼吸暂停低通气综合征 (OSAHS)患者临床特点和悬雍垂腭咽成形术 (UPPP)手术疗效。方法 回顾性分析所收治的轻、中度OSAHS患者 32 0例体会。结果 术后 6个月复查治愈 2 2 8例 (71 2 1% ) ,有效 76例(2 3 75 % ) ,无效 16例 (5 0 0 % ) ,总有效率 94 96 %。对术后 1～ 10a按孙济治 1997年鼾症手术治愈标准 ,随访 10 0例 ,临床治愈6 2例 ,好转 2 0例 ,远期有效率 82 %。复发 10例 (占 10 % ) ,术后测量咽腔左右径扩大 2 0cm ,前后径扩大 1 0cm。结论 手术是解决OSAHS较有效的方法 ,UPPP是治疗OSAHS最好的术式 ,手术操作的技巧是提高疗效的关键。UPPP近期疗效达 95 % ,远期治愈率为 6 2 % 。

Objective To observe the clinical characteristics of obstructive sleep apnea- Hypopnea syndrome (OSAHS) and the efficacy of uvulopalato pharyngoplasty(UPPP).Methods A retrospective anslysis of the clinical data of 320 mild to moderate OSAHS patients treated from January 1986 to December 2002 was carried out.Results All patients were followed up 6 months after operation,of whom 228(71.21%) were cured,76(23.75%) improved,and 16(5.00%) failed,with a total effective rate of 94.96%.According to the Snoring Disease Operative criteria of 1997,100 cases were followed up one to ten years after operation,of whom 62 were cured,20 improved,and 18 failed or had relapse,with a late effective rate of 82%.Postoperative pharyngeal cavity was estimated to be 2.0 cm wider and 1.0 cm longer than before.Conclusions Surgical operation is the best method for treating OSAHS,and UPPP is the most effective surgery for treating snoring diseases.The key to raising the effective rate is proper pre-operation selection of patients,reasonable surgical type,and competent skills.Short term effective rate reaches 95%,and long-term effective rate is 62%.Factors directly related to surgical effectiveess include proper treatment of related diseases.