Z形腭成形术治疗重度OSAHS的疗效观察

王林; 刘吉祥; 王颖; 杨春伟; 秦永欣

doi:10.13201/j.issn.1001-1781.2012.06.012

Z形腭成形术治疗重度OSAHS的疗效观察

- 天津市人民医院耳鼻咽喉头颈外科(天津, 300121)

详细信息

通讯作者: 王林,E-mail:tjwlin@hotmail.com

中图分类号: R563.8

收稿日期: 2011-05-04

Result of Z-palatoplasty for treating severe obstructive sleep apnea hypopnea syndrome

- Department of Otorhinolaryngology-Head and Neck Surgery, Tianjin People's Hospital, Tianjin, 300121, China

More Information

Corresponding author: WANG Lin, E-mail: tjwlin@hotmail.com

Received Date: 04 May 2011

摘要

摘要: 目的:探讨Z形腭成形术(ZPP)在治疗重度OSAHS患者的应用及疗效影响因素。方法:32例重度OSAHS的患者,扁桃体均0~Ⅰ度。其中,FriedmanⅡ型、改良Mallampati指数(MMI)舌肥厚Ⅰ~Ⅱ度患者9例单纯行ZPP,FriedmanⅢ型、MMI舌肥厚为Ⅲ~Ⅳ度患者23例行ZPP加舌根等离子打孔消融术。32例患者术后随访1年,观察指标包括:BMI、Epworth嗜睡量表(ESS)评分、AHI、LSaO₂及血氧饱和度低于0.90的时间占总睡眠时间百分比(CT90)。结果:手术后AHI从(54.74±20.38)下降到(22.72±18.36),平均LSaO₂从(74±12)%上升至(85±14)%,ESS评分从(12.24±5.78)下降到(5.35 ±3.62),CT90从(31.48±20.15)下降到(15.73±12.29),各相关测量值的变化均具有统计学意义(P<0.01)。疗效评定结果:治愈5例,显效18例,有效4例,无效5例,总有效率为84.4％;按AHI<20且下降>50％计,显效率71.9％。术后暂时性腭咽关闭不全6例,均在术后3个月内恢复正常。结论:ZPP是治疗Friedman Ⅱ、Ⅲ型重度OSAHS患者的一种有效、安全的治疗方法。
- 腭成形术 /
- 睡眠呼吸暂停低通气综合征,阻塞性
Abstract: Objective: To investigate the efficacy and related factors of Z-palatoplasty for treating severe obstructive sleep apnea hypopnea syndrome(OSAHS).Method: Thirty-two severe OSAHS patients with Friedman Ⅱ and Ⅲ oropharyngeal airway had Z-palatoplasty.Twenty-three patients with modified Mallampti Index(MMI) Ⅲ-Ⅳ had coblation tongue channeling(CTC) simultaneously.The patients were followed up for one year post operatively.Result: After operation, the apnea and hypopnea index(AHI) decreased from(54.74±20.38)/h to (22.72±18.36)/h; the lowest artery oxygensaturation(LSaO₂) increased from(0.74±0.08) to (0.85±0.14); the Epworth sleep scale(ESS) decreased from(12.24±5.78) to (5.35±3.62); the percentage of time with oxyhemoglobin saturation below 0.90(CT90) decreased from(31.48±20.15) to (15.73±12.29). All of the differences were statistically significant(P<0.01). According to related criterion of chinese journal of otorhinalaryngology head and neck surgery in 2009, accumulative excellence rate was 71.9% and accumulative valid rate 84.4%. Six patients had temporary velopharyngeal insufficiency and returned to normal after 3 months.Conclusion: Z-palatoplasty is an effective and safe surgical approach for OSAHS patients with Friedman Ⅱ/Ⅲ.
- palatoplasty /
- sleep apnea hypopnea syndrome,obstructive

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参考文献(6)

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