山东大学耳鼻喉眼学报 ›› 2009, Vol. 23 ›› Issue (4): 12-14.

• 论文 • 上一篇    下一篇

软腭、舌体低温等离子消融配合H-UPPP治疗重度OSAHS 30例分析

许振跃 方铭达 洪斌 李兆生   

  1. 福建医科大学附属漳州市医院耳鼻咽喉科,福建 漳州 363000
  • 收稿日期:2009-05-24 修回日期:2009-07-31 出版日期:2009-08-16 发布日期:2009-08-16
  • 作者简介:许振跃(1969- ),男,副主任医师、主要从事各种耳鼻咽喉科疾病、鼾症治疗及内镜外科研究。 Email:dtxu203@163.com

Thirty cases of severe OSAHS treated by combination of H-UPPP and low-temperature plasma of the soft palate and corpus linguae

 XU Zhen-Yue, FANG Ming-Da, HONG Bin, LI Zhao-Sheng   

  1. Department of Otorhinolaryngology,Zhangzhou Affiliated Hospital of Fujian  Medical University, Zhangzhou 363000, Fujian, China
  • Received:2009-05-24 Revised:2009-07-31 Online:2009-08-16 Published:2009-08-16

摘要:

目的 探讨应用改良的悬雍垂腭咽成形术(H-UPPP)配合软腭、舌体低温等离子消融治疗腭-咽平面、舌-咽平面阻塞所致的重度阻塞性睡眠呼吸暂停低通气综合征的可行性、优越性和注意事项。方法 对30例经多导睡眠监测,Muller动作检测确定的因腭-咽平面、舌-咽平面阻塞所致的重度阻塞性睡眠呼吸暂停低通气综合征患者进行了改良的悬雍垂腭咽成形术(H-UPPP)配合软腭、舌体低温等离子消融,术中完整保留悬雍垂,切除腭帆间隙脂肪组织,扩大软腭成形范围,并于软腭及舌体低温等离子打孔消融,全部患者均分别进行了术前和术后6个月、1年、3年多导睡眠监测。结果 按照杭州会议疗效评定标准,6月内有效率100.00%,1年有效率83.33%,3年有效率76.67%,无1例术中或术后行气管切开术,无1例出现软腭粘连、鼻咽狭窄、大出血、开放性鼻音、死亡。结论 对腭-咽平面、舌-咽平面阻塞所致的重度阻塞性睡眠呼吸暂停低通气综合征的患者,软腭、舌体低温等离子消融配合H-UPPP治疗是安全、有效的,具有简单、微创,无需气管切开,愈合快等优点,同时应注意术前应用CPAP治疗,全麻清醒后24h才拔出气管插管。

关键词: 重度阻塞性睡眠呼吸暂停低通气综合征;软腭、舌体;低温等离子消融;改良的悬雍垂腭咽成形术

Abstract:

Objective To explore the feasibility, superiority and matters for attention of the modified H-UPPP combined with the treatment of low-temperatureplasma of the soft palate and corpus linguae for severe OSAHS.  Methods  30 casesof severe OSAHS with velo and tongue pharyngeal obstruction diagnosed by polysomnography and by Muller's maneuver were treated surgically by H-UPPP combinedwith treatment of the low-temperature plasma of the soft palate and corpus linguae. The uvula was preserved completely in the operation and the flat oropharyngeal civility was cut. All the patients accepted polysomnography before the operation, 6-month, 1-year and 3-year after the operation.  Results  The responses for 6-month, 1-year and 3-year were 100%, 83.33%, and 76.67% respectively. No case underwent tracheotomy during and after operation. No velopalatal insufficiency occurred. Conclusions The combined treatment of OSAHS is simple, safe and effective. It needs no tracheotomy and has less injury and rapid recovery. The treatment of CPAP is necessary before operation and the tracheacanula should be removed 24h after waking.

Key words: Severe obstructive sleep apnea-hypopnea syndrome; Soft palate and corpus linguae; Treatment of the low-temperature plasma; Modified uvulopalatopharyngoplasty

中图分类号: 

  • R766.9
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