摘要
目的改良腭咽成形术结合射频技术形成针对不同病态上气道形态的个性化术式。方法34例患者经多导睡眠监测(polysomnography,PSG)确诊为中或重度阻塞性睡眠呼吸暂停低通气综合征(obstructivesleepapneahypopneasyndrome,OSAHS);根据气道形态将传统腭咽成形术(uvulopalatopharyngoplasty,UPPP)改良为侧重扩大横径和扩大矢径两种术式,并选择性地进行局部射频消融。全部患者以治疗前后的PSG、咽腔测量数据及主观感觉等指标作对照。结果随访30例患者,术后6个月复查睡眠呼吸暂停低通气指数(apneahypopneaindex,AHI)值由54.7±18.2降至26.4±8.6(P﹤0.01),总有效率86.7%。结论改良腭咽成形术结合射频技术以气道形态改变为基础选择手术适应证,可明显提高疗效。
OBJECTIVE On the basis of the different shapes of upper airway（UA）obstruction and collapse characteristic of obstructive sleep apnea hypopnea syndrome（OSAHS）, the effect of modified uvulopalatopharyngoplasty（U PPP）combined with coblation in OSAHS operations on patients with AHI ≥20,which could be done selectively to patients with various or multiple UA obstructive sites, was explored. METHODS 30 patients of OSAHS were diagnosed and analysed by polysomnography（PSG）to have AHIs≥20. Based on the shapes of their UAs classified according to the degree of the shortened lateral and radial vectors,the UPPP was modified in two ways： either the lateral vector or the radial vector was amplified, or both could be amplified with coblation. All patients were analyzed by questionnaires（PSG）Muller＇s maneuver and oral cavity measurement pre-and 6 months postoperation. RESULTS 86.7 % of the patients showed a decrease of at least 25 % in AHI . Velopalatal insufficiency never occurred. CONCLUSION The modified-UPPP combined with coblation can be used selectively on patients based on their UA shapes.
出处
《中国耳鼻咽喉头颈外科》
北大核心
2006年第3期181-183,共3页
Chinese Archives of Otolaryngology-Head and Neck Surgery
