关键词: 睡眠呼吸暂停, 阻塞性, 外科手术, 多道睡眠描记术, 治疗结果

Abstract: To explore the effect of H-uvulopalatopharyngoplasty (H-UPPP) and nasal cavity aerated and volume extension(NCAVE) in treatment of medium and severe obstructive sleep apnea hypopnea syndrome (OSAHS). Methods38 cases (male 28 and female 10), aging from 24 to 76 years old (average 46.18) were diagnosed by polysomnography (PSG) as medium or severe OSAHS from Jan. 2005 to Sep. 2006 in our hospital. They were semi-randomly divided into groups A and B. BMI, Friedman degree, nasal acoustic reflection and nasal airway resistance were all not statistically different between the two groups. Group A was first treated by H-UPPP and then NCAVE including inferior turbinate bone resection and nasal septal reconstruction, and group B was first treated by NCAVE and then H-UPPP. The tests were rechecked at the end of the 1st or the 6th month after the operations. All parameters were analyzed by software SPSS 10.0. ResultsClinical manifestations such as snoring, suffocating, headache, drowsiness, etc. were apparently mitigated or eliminated in 6 months after the operations. Based on the Hangzhou standard, 7 cases were cured, 27 cases had an effect, and the total response rate was 97.37%. Pre-operative levels of AHI, LSaO2 and AHTI were statistically different from post-operative levels. Nasal acoustic reflection was increased from 10.14±3.54 cm3 to 15.03±3.29 cm3 and nasal airway resistance was decreased from 0.64±0.53 Pa·s/cm3 to 0.20±0.14 Pa·s/cm3 (P＜0.01). Velopharyngeal close insufficiency or atresia was not found.　ConclusionsH-UPPP enlarges pharyngeal left-right and anterior-posterior diameters. Either H-UPPP or NCAVE could improve the AHI, LSaO2 and AHTI levels, however, combined together they can give a better effect.

Key words: obstructive, Surgical procedures, Sleep apnea hypopnea, operative, Polysomnography, Treatment outcome