低温等离子辅助改良腭咽成形联合舌减容和鼻腔扩容术对中重度OSAHS的近期疗效和安全性评价

doi:10.6040/j.issn.1673-3770.0.2016.490

山东大学耳鼻喉眼学报 ›› 2017, Vol. 31 ›› Issue (1): 50-54.doi: 10.6040/j.issn.1673-3770.0.2016.490

低温等离子辅助改良腭咽成形联合舌减容和鼻腔扩容术对中重度OSAHS的近期疗效和安全性评价

怀德¹,殷敏²,张希龙³,汪守峰¹,解成兰⁴,徐敏⁵,戴俊¹,蔡菁菁¹,曹影¹,金同爱¹,程雷²

1.徐州医科大学附属淮安医院/淮安市第二人民医院耳鼻咽喉科, 江苏淮安 223002;
2.南京医科大学第一附属医院/江苏省人民医院耳鼻咽喉科, 江苏南京 210029;
3.南京医科大学第一附属医院/江苏省人民医院呼吸与危重症医学科, 江苏南京 210029;
4.徐州医科大学附属淮安医院/淮安市第二人民医院麻醉科, 江苏淮安 223002;
5.徐州医科大学附属淮安医院/淮安市第二人民医院影像科, 江苏淮安 223002

收稿日期:2016-11-21 出版日期:2017-02-16 发布日期:2017-02-16
通讯作者: 程雷. E-mail:jspent@126.com
基金资助:
江苏省“333高层次人才培养工程”资助科研项目(BRA-2014131);江苏省淮安市2016年重点研发计划项目(社会发展)(HAS201611)

Modified UPPP with low-temperature plasma tongue volume reduction and selective nasal cavity expansion for moderate to severe OSAHS: short-term efficacy and safety evaluation.

1. Department of Otorhinolaryngology, Huaian Second Peoples Hospital, Affiliated Huaian Hospital of Xuzhou Medical University, Huaian 223002, Jiangsu, China;2. Department of Otorhinolaryngology, the First Affiliated Hospital of Nanjing Medical University, Nanjing 210029, Jiangsu, China;3. Department of Respiratory and Critical Care Medicine, the First Affiliated Hospital of Nanjing Medical University, Nanjing 210029, Jiangsu, China;4. Department of Anesthesiology, Huaian Second Peoples Hospital, Affiliated Huaian Hospital of Xuzhou Medical University, Huaian 223002, Jiangsu, China;5. Department of Radiology, Huaian Second Peoples Hospital, Affiliated Huaian Hospital of Xuzhou Medical University, Huaian 223002, Jiangsu, China;

Received:2016-11-21 Online:2017-02-16 Published:2017-02-16

摘要/Abstract

摘要： 目的探讨低温等离子辅助改良悬雍垂腭咽成形术(UPPP)、舌减容联合选择性鼻腔扩容术治疗中重度阻塞性睡眠呼吸暂停低通气综合征(OSAHS)的近期疗效、安全性及临床应用价值等。方法回顾分析淮安市第二人民医院耳鼻咽喉科2013年10月~2016年5月收治的164例中重度OSAHS患者,按手术方式不同分为观察组和对照组,每组82例患者。观察组在充分围手术期准备的基础上,采取低温等离子辅助改良UPPP、舌体舌根减容以及选择性鼻腔扩容术,对照组常规UPPP加鼻腔扩容术进行治疗。比较两组临床疗效、手术并发症情况等指标。结果术后随访6个月,观察组和对照组的总有效率分别为81.7%和62.2%,差异有统计学意义(P<0.05)。随访1年,观察组和对照组的总有效率分别为75.6%和51.2%,差异也有统计学意义(P<0.05)。观察组手术并发症发生率明显低于对照组(P<0.05)。结论对有手术适应证的中重度OSAHS行低温等离子辅助改良UPPP联合舌减容和选择性鼻腔扩容术,可取得较为满意的治疗效果,安全性良好,但术后1年以上的远期疗效有待进一步随访观察。

关键词: 悬雍垂腭咽成形术, 鼻腔扩容术, 舌减容术, 睡眠呼吸暂停,阻塞性, 低温等离子

Abstract: Objective To explore the clinical efficacy, safety and value of modified uvulopalatopharyngoplasty(UPPP)versus low-temperature plasma and selective nasal cavity vasodilatation with tongue volume reduction in the treatment of moderate and severe obstructive sleep apnea hypopnea syndrome(OSAHS). Methods The clinical data of 164 patients with moderate or serious OSAHS treated during Octorber, 2013 and May, 2016 were retrospective analyzed. According to the different surgical approaches, patients were divided into two groups: the observation group(n=82)and the control group(n=82). Patients in the observation group received modified UPPP versus low-temperature plasma and selective nasal cavity vasodilatation with tongue volume reduction, while patients in the control group underwent routine UPPP and nasal cavity vasodilatation. The clinic efficacy, operative complications, postoperative relapse and other indexes of the two groups were compared. Results Six months after surgery, the general effective rate of the observation group and control group was 81.7% and 62.2%, respectively, with statistically significant difference(P<0.05). One year after surgery, the general effective rate of the observation group and control group was 75.6% 山东大学耳鼻喉眼学报31卷1期 -怀德,等.低温等离子辅助改良腭咽成形联合舌减容和鼻腔扩容术对中重度OSAHS的近期疗效和安全性评价 \=-and 51.2%, respectively, with statistically significant difference(P<0.05). Fewer complications occurred in the observation group than in the control group. Conclusion The efficacy of modified UPPP plus low-temperature plasma and selective nasal cavity vasodilatation with tongue volume reduction can produce satisfactory clinical outcome for patients with moderate or severe OSAHS.

Key words: Sleep apnea, obstructive, Uvulopalatopharyngoplasty, Tongue volume reduction, Nasal cavity expansion, Low-temperature plasma

中图分类号:

R766.7

怀德,殷敏,张希龙,汪守峰,解成兰,徐敏,戴俊,蔡菁菁,曹影,金同爱,程雷. 低温等离子辅助改良腭咽成形联合舌减容和鼻腔扩容术对中重度OSAHS的近期疗效和安全性评价[J]. 山东大学耳鼻喉眼学报, 2017, 31(1): 50-54.

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低温等离子辅助改良腭咽成形联合舌减容和鼻腔扩容术对中重度OSAHS的近期疗效和安全性评价

Modified UPPP with low-temperature plasma tongue volume reduction and selective nasal cavity expansion for moderate to severe OSAHS: short-term efficacy and safety evaluation.

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