OSAS患者经射频组织缩积术治疗的疗效评价

The curative effect appraisal of radiofrequency volumetric tissue reduction on obstructive sleep apnea syndrome

目的 观察射频组织缩积术 (RFTVR)行悬雍垂、软腭成形术治疗阻塞性睡眠呼吸暂停综合征的疗效。方法 应用RFTVR在局麻下对 1 8例平均年龄 (4 2 .2± 5 .6 )岁的男性轻、中度阻塞性睡眠呼吸暂停患者 (1 2例为软腭肥大者 ,6例为悬雍垂粗长患者 )行悬雍垂、软腭成形术治疗。手术前后均行多导睡眠图监测检查。结果 1 8例患者术后 4～ 8周随访 ,病情显著改善 ,各种临床症状缓解 ,打鼾明显降低 ,软腭游离缘、悬雍垂缩短。多导睡眠图检查提示 :患者平均呼吸暂停低通气指数 (AHI)由术前1 9 .1± 7.3减少至 5 .9± 4 .4 (P <0 .0 1 ) ,平均最低血氧饱和度 (SaO2 )由术前 (80 .5± 5 .7) %升高到 (91 .7± 7.3) % (P <0 .0 5 )。结论 射频组织缩积术是一项新的微创、安全的治疗方法 ,能够有效治疗轻、中度阻塞性睡眠呼吸暂停综合征。严格选择手术适应证大多数患者近期可收到显著疗效 。

Objective To observe the curative effect of radiofrequency volumetric tissue reduction (RFTVR) and plastic surgery of uvula and soft palate on obstructive sleep apnea syndrome.Methods RFTVR under the condition of local anesthesia were performed in eighteen male patients of this disease (low grade and moderate) aged 42.2±5.6 (twelve cases of soft palate hypertrophy and six cases of uvula tumefaction) in the treatment of plastic surgery of uvula and soft palate.Polysomonography inspection was used before and after the operation.Results We found that all the eighteen patients were in an obvious good state in the following four to eight weeks of random visit after the operation.Various clinical symptoms were reduced such as obvious reduced snores,the normalness of soft palate and uvula etc.Polysomonography inspection indicated that the exponent of patients AHI reduced from 19.1±7.3 before the operation to 5.9±4.4 ( P <0.01) after the operation;and also SaO 2 increased from (80.5±5.7)% to (91.7± 7.3 )% ( P <0.05).Conclusion Radiofrequency volumetric tissue reduction (RFTVR) is a new and safe treatment,which can only cause slight hurt and be used effectively to the treatment of low grade and moderate obstructive sleep apnea syndrome.If strictly choose operation adaptive patients,salient curative effects can be achieved in the near future and its long term effects are still under observation.