山东大学耳鼻喉眼学报 ›› 2024, Vol. 38 ›› Issue (3): 49-54.doi: 10.6040/j.issn.1673-3770.0.2023.488
• 论著 • 上一篇
王桂芳,李仁高,马青
WANG Guifang, LI Rengao, MA Qing
摘要: 目的 探讨改良悬雍垂腭咽成形术(han-uvulopalatopharyngoplasty, H-UPPP)联合低温等离子舌根射频消融术对阻塞性睡眠呼吸暂停低通气综合征(obstructive sleep apnea hypopnea syndrome, OSAHS)患者血氧饱和度及动脉血氧分压(arterial partial pressure of oxygen, PaO2)的影响。 方法 选取OSAHS患者72例,根据手术方式将其分为H-UPPP手术组(采用单一H-UPPP治疗)和联合手术组(采用H-UPPP联合低温等离子舌根射频消融术治疗),有2例失访,最终70例纳入本研究,其中H-UPPP手术组35例,联合手术组35例;比较两组术前和术后6个月低通气指数(apnea hypopnea index, AHI)、最低血氧饱和度(lowest oxygen saturation, LSaO2)、PaO2、动脉血二氧化碳分压(arterial partial pressure of carbon dioxide, PaCO2)、用力肺活量、第1秒用力呼气容量、Epworth嗜睡量表(epworth sleepiness scale, ESS)评分及模拟视觉量表(visual analogue scale, VAS)评分,观察两组临床疗效及术后不良反应。 结果 术后6个月,联合手术组和H-UPPP手术组AHI和PaCO2较术前均降低,LSaO2、PaO2均增加(P均<0.05),联合手术组AHI低于H-UPPP手术组,LSaO2、PaO2高于H-UPPP手术组(P=0.036、0.030、0.001),但组间PaCO2比较差异无统计学意义(P=0.737);联合手术组和H-UPPP手术组用力肺活量、第1秒用力呼气容量较术前均增加(P均<0.05),联合手术组用力肺活量、第1秒用力呼气容量均大于H-UPPP手术组(P均<0.001);两组ESS评分均降低,VAS评分均升高,联合手术组ESS评分低于H-UPPP手术组,VAS评分高于H-UPPP手术组。联合手术组治疗总有效率高于H-UPPP手术组(P=0.025);两组术后并发症总发生率比较,差异均无统计学意义(P=0.353)。 结论 H-UPPP联合低温等离子舌根射频消融术可有效促进OSAHS患者肺功能恢复,改善LSaO2、PaCO2及PaO2,临床疗效较好,安全性较佳。
中图分类号:
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