山东大学耳鼻喉眼学报 ›› 2012, Vol. 26 ›› Issue (1): 1-3.

• 论文 •    下一篇

同期手术治疗三重平面阻塞的阻塞性睡眠呼吸暂停低通气综合征

蔡谦,邹华,关中,郑亿庆,刘翔,黄晓明   

  1. 中山大学附属第二医院耳鼻咽喉头颈外科, 广州  510120
  • 收稿日期:2011-07-09 出版日期:2012-02-16 发布日期:2012-02-16
  • 作者简介:蔡谦(1975- ),医学博士,主治医师。 Email: caiq163@126.com
  • 基金资助:

    教育部高等学校博士学科点新教师基金(20090171120074);广东省医学科学基金(B2009072)

One-stage surgical approach on obstructive sleep apnea hypopnea syndrome with triple plane obstructions

CAI Qian, ZOU Hua, GUAN Zhong, ZHENG Yi qing, LIU Xiang, HUANG Xiao ming   

  1. Department of Otolaryngology, the Second Affiliated Hospital, Sun Yatsen University, Guangzhou 510120, Guangdong, China
  • Received:2011-07-09 Online:2012-02-16 Published:2012-02-16

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)患者同期手术治疗的疗效。方法   对35例鼻腔、口咽、舌根三重平面狭窄的OSAHS患者,采用保留悬雍垂的腭咽成形术(UPPP)和同期下鼻甲及舌根射频消融技术治疗,术后放置鼻咽通气管24~48h。结果   35例患者手术完成顺利。8例(22.9%)患者术后出现不适感,其中术后5d内出现鼻腔返流1例(2.9%),经口咽雾化治疗使咽部组织水肿消除后症状消除;出现味觉减退1例(2.9%);随访时仍有轻微咽干、咽异物感或咽痛6例 (17.1%)。无讲话欠清晰、吞咽费力、死亡或其他严重并发症出现。术后复查,治愈5例,显效13例,有效8例,无效9例,总有效率为74.3%(26/35)。短期、长期随访有效率分别为81.3%、68.4%。结论   采用射频消融技术联合UPPP手术对三重平面阻塞的OSAHS患者治疗安全有效。

关键词: 睡眠呼吸暂停,阻塞性;手术治疗;射频消融;悬雍垂腭咽成型术

Abstract:

Objective   To investigate the effectiveness of one-stage surgical approach on OSAHS (obstructive sleep apnea hypopnea syndrome) with triple plane obstructions. Methods   Thirty-five OSAHS patients (male 32, female 3; age range 39±7 ys; BMI 27.5±2.3kg/m2; moderate 9, severe 26) with stenosis in nasal cavity, oropharynx and lingual root were treated in the Second Affiliated Hospital of Sun Yat-sen University between Sept. 2006 and Jan. 2010. They underwent uvulopalatopharyngoplasty (UPPP), combined with radiofrequency ablation of inferior nasal concha and lingual root. Nasopharyngeal tube was planted postoperatively for 24 to 48 hs. Results   Among the 35 patients, 8 (22.9%) patients presented discomfortableness. Nasal  backflow appeared five days after the surgery in one (2.9%) patient, but recovered after the tissue edema eliminated by oropharyngeal atomization treatment. One (2.9%) patient suffered from hypogeusia and six (17.1%) presented slight pharyngeal dryness, foreign body sensation, or sore throat. No blurred speaking or difficult swallowing occurred.  No death or other serious complications appeared. Postoperative review showed the cure were achieved in 5 cases, excellent effect in 13, effect in 8, and no effect in 9. The total effective rate was 74.3% (26/35). Effective rate of short-term and longgerm followup were 81.3% and 68.4%, respectively. Conclusion   Radiofrequency ablation combined with UPPP is safe and effective in treating OSAHS with triple plane obstructions.

Key words: Obstructive sleep apnea hypopnea syndrome; Surgery; Radiofrequency ablation; Uvulopalatopharyngoplasty

中图分类号: 

  • R766.7
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