山东大学耳鼻喉眼学报 ›› 2013, Vol. 27 ›› Issue (3): 4-6.doi: 10.6040/j.issn.1673-3770.0.2013.011

• 睡眠呼吸障碍性疾病 • 上一篇    下一篇

多平面手术治疗阻塞性睡眠呼吸暂停低通气综合征的疗效观察

赵玮1,顾朝辉1,周岩1,胡雁1,何静2   

  1. 1.保定市第一中心医院耳鼻喉科, 河北 保定  071000;
    2.秦皇岛市昌黎县人民医院耳鼻喉科, 河北 昌黎  066600
  • 收稿日期:2012-11-20 发布日期:2013-06-16
  • 作者简介:赵玮。 Email: doczhaowei@163.com

Therapeutic effects of multiplanar operation for the obstructive sleep apnea hypoventilation syndrome

ZHAO Wei1,  GU Zhao-hui1, ZHOU Yan1, HU Yan1,  HE Jing2   

  1. 1. Department of Otolaryngology, the No.1 Central Hospital, Baoding 071000, Hebei, China; 2. Department of Otolaryngology,  the Qin Huang Dao Changli  Country  Hospital, Changli  066600, Hebei, China
  • Received:2012-11-20 Published:2013-06-16

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。

关键词: 睡眠呼吸暂停, 多平面手术, 舌骨悬吊术

Abstract:

Objective   To investigate the effect of  one stage multiplanar operation for the obstructive sleep apnea hypoventilation syndrome(OSAHS). Mehods   68 cases with nasal、 palatopharyngeal and oropharyngeal obstruction received 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 operation can  effectively  prevent postoperative severe complications.

Key words: hyoid suspension, Obstructive sleep apnea hypopnea syndrome; multiplanar operation

中图分类号: 

  • R766.7
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