CO2激光辅助改良腭咽成形加选择性鼻腔扩容术治疗中重度阻塞性睡眠呼吸暂停低通气综合征

Improvement of CO_2 laser assisted uvulopalatopharyngoplasty with selective expansion of the nasal cavity for the treatment of the moderate to severe obstructive sleep apnea hypopnea syndrome

目的探讨CO2激光辅助改良悬雍垂腭咽成形术(UPPP)联合选择性鼻腔扩容术治疗中重度阻塞性睡眠呼吸暂停低通气综合征(OSAHS)的临床疗效、应用价值等。方法回顾分析淮安市第二人民医院耳鼻咽喉科2012年4月至2015年4月收治的186例中重度OSAHS患者,按手术方式不同分为观察组和对照组,每组93例患者。观察组在充分围手术期准备的基础上采取CO2激光辅助改良UPPP联合舌根淋巴滤泡处理加选择性鼻腔扩容术,对照组常规手术方法治疗。术后比较两组临床疗效、手术并发症及术后复发情况等指标。结果随访6个月后,观察组和对照组的总有效率分别为83.87%和67.79%,差异有统计学意义(P<0.05)。除此以外,观察组并发症发生率也明显低于对照组。结论对有适应证的中重度OSAHS,经充分围手术期准备,行CO2激光辅助改良UPPP联合选择性鼻腔扩容术等综合治疗,经规范随访,效果较为肯定,值得临床推广应用。

Objective To investigate the CO2 laser assisted uvulopalatopharyngoplasty(UPPP) combined with selective expansion of the nasal cavity for the treatment of the moderate to severe OSAHS patients in effect and application value. Methods A retrospective analysis of 186 cases of the moderate to severe OSAHS patients which dated from April 2012 to April 2015 of Huai’an Second People’s Hospital according to the operation method was performed, these patients were divided into two groups, observation group and control group, with 93 patients each. The research group received CO2 laser assisted modified UPPP combined with selective expansion nasal surgery, and the other one with traditional surgery, followed up to observe the curative effect and recurrence rate between the two groups. Results For follow-up of 6 months, total effective rate of observation group was 83.87% and the effective rate of control group was respectively 67.79%. The total effective rate of observation group was higher than the control group, and non efficiency rate was lower than that of the control group; besides that the incidence of complications and the recurrence rate of the observation group was lower than the control group. Conclusion After sufficient perioperative preparation, the moderate to severe OSAHS patients with indications have received integrated treatment, including modified CO2 laser-assisted UPPP plus selective nasal expansion, etc. According to results of standard follow-up visit, the effect is quite positive, so it is worthy of clinical promotion and application.