摘要
目的探讨对三重平面阻塞的阻塞性睡眠呼吸暂停低通气综合征(OSAHS)患者同期行多平面手术治疗的疗效。方法对68例鼻腔、口咽、舌咽三重平面狭窄的OSAHS患者,采用保留悬雍垂的腭咽成形术(H-UPPP)、鼻腔结构重建及改良下颌骨舌骨悬吊术,对重度OSAHS患者术前经鼻持续正压通气治疗(CPAP)。结果 68例患者手术完成顺利,无死亡及其他严重并发症发生。多导睡眠监测(PSG)显示,术后6个月有效率100%,术后1年有效率95.55%。手术前、术后6个月、术后1年睡眠呼吸紊乱指数(AHI)及最低SaO2差异均有统计学意义(P<0.05);手术前、术后6个月、术后1年CT检查发现舌后区前后径减小,左右径增大,P<0.05,气道形态明显改善。结论采用同期多平面手术对三重平面阻塞的OSAHS患者治疗有效,术后气道形状逐渐趋向正常人的气道形状,术前CPAP治疗可预防严重并发症发生。
Objective To investigate the effect of one stage multiplanar operation for the obstructive sleep apnea hy poventilation syndrome（OSAHS）. Mehods 68 cases with nasal, palatopharyngeal and oropharyngeal obstruction re ceived H-uvulopalatopharyngoplasty（ H-UPPP）, nasal reconstruction and hyoid suspension. Before the operation, some severe cases underwent continuous positive airway pressure（CPAP） therapy or tracheotomy. Results In 68 cases, all the operations were performed successfully. No death or severe complications occurred during the operation and follow up. According to polysomnography（PSG）, the effectiveness was 100% 6 months later and 95.55% after one year. 6 months and one year after the operation, the changes of AHI and SaO2 were significant （ P 〈 0.05 ） compared with those preoperative. On CT scanning, the anteroposter dimensions of retroglossal areas were decreased, and retropalatal areas were increased after surgery （ P 〈 0.05 ）. The shape of airway was improved significantly. Conclusion The one stage multiplanar operation is safe and effective for OSAHS. The shape of airway tends to be normal. CPAP before the oper ation can effectively prevent postoperative severe complications.
出处
《山东大学耳鼻喉眼学报》
CAS
2013年第3期4-6,9,共4页
Journal of Otolaryngology and Ophthalmology of Shandong University
关键词
睡眠呼吸暂停
多平面手术
舌骨悬吊术
Obstructive sleep apnea hypopnea syndrome
multiplanar operation
hyoid suspension
