摘要
目的 探讨改良悬雍垂腭咽成形术（H-UPPP）联合软腭前移术（PA）对阻塞型睡眠呼吸暂停低通气综合征患者术后上气道结构变化的影响.方法 选取86例阻塞型睡眠呼吸暂停低通气综合征患者,分别行单纯H-UPPP（对照组,39例）或H-UPPP联合PA（观察组,47例）治疗.比较两组手术前后上气道结构指标CT测量值和呼吸暂停低通气指数（AHI）的变化.结果 观察组手术有效率为80.9％（38/47）,显著高于对照组的56.4％（22/39）,差异有统计学意义（P＜0.05）.观察组和对照组手术前后AHI降低值分别为（40.5±14.6）次/h和（16.7±12.0）次/h,硬腭长度减小值分别为（5.5±3.2）mm和（1.6±0.2）mm,硬腭前后径增加值分别为（3.6±2.3）mm和（-1.6±3.4）mm,腭咽前后径增加值分别为（1.6±1.2） mm和（-1.2±1.8）mm,观察组改善情况明显优于对照组,差异均有统计学意义（P＜0.05）.对照组舌咽区气道最小左右径增加值为（13.2±3.1）mm,显著大于观察组的（4.9±1.6）mm,差异有统计学意义（P＜0.05）.结论 H-UPPP联合PA较单纯行H-UPPP对阻塞型睡眠呼吸暂停低通气综合征患者疗效显著,对AHI的降低作用更明显,其机制可能是通过更有效扩大腭咽区气道的前后径实现的.
Objective To compare the upper airway changes after H-uvulopalatopharyngoplasty （H-UPPP） combined with transpalatal advancement pharyngoplasty （PA） in patients with obstructive sleep apnea hypopnea syndrome （OSAHS）.Methods Eighty-six patients with OSAHS were selected,39 patients were treated with H-UPPP alone （control group）,and 47 patients were treated with H-UPPP combined with PA （observation group）.The upper airway changes were measured by CT and apnea hypopnea index （AHI） change in the 2 groups were compared before and after operation.Results The surgery effective rate in observation group was 80.9% （38/47）,in control group was 56.4% （22/39）,there was statistical difference （P 〈 0.05）.The AHI depressed value before and after operation in observation group and control group were （40.5 ± 14.6） times/h and （16.7 ± 12.0） times/h respectively,the hard palate length depressed value were （5.5 ± 3.2） mm and （1.6 ± 0.2） mm respectively,the anteroposterior diameter incremental value of hard palate were （3.6 ± 2.3） mm and （-1.6 ± 3.4） mm respectively,the anteroposterior diameter incremental value of palate and pharynx were （1.6 ± 1.2） mm and （-1.2 ± 1.8） mm respectively,the above indexes in observation group were significantly better than those in control group,there were statistical differences （P 〈 0.05）.The minimum diameter incremental value of retropalatal airway in control group was （13.2 ± 3.1） mm,in observation group was （4.9 ± 1.6） mm,there was statistical difference （P 〈 0.05）.Conclusion H-UPPP combined with PA offers benefit over H-UPPP alone in patients with OSAHS,which may be achieved by increasing anteroposterior diameter of palate and pharynx.
出处
《中国医师进修杂志》
2014年第9期36-39,共4页
Chinese Journal of Postgraduates of Medicine
关键词
睡眠呼吸暂停
阻塞性
上气道
改良悬雍垂腭咽成形术
软腭前移术
Sleep apnea,obstructive
Upper airway
H-uvulopalatopharyngoplasty
Transpalatal advancement pharyngoplasty
