The efficacy evaluation of multiplane operations in obstructive sleep apnea-hypopnea syndrome
-
摘要: 目的:探讨OSAHS患者多平面手术治疗的效果。方法:115例OSAHS患者行UPPP,其中加鼻中隔偏曲矫正术18例,加鼻中隔偏曲矫正术、下鼻甲部分切除术26例,加颏舌肌前徙术和舌体部分切除术1例,加舌体部分切除术5例。其中伴鼻部疾病和(或)舌体肥大、AHI>40和(或)BMI>30的患者术前行气管切开后插管全身麻醉。结果:术后长期随访,治愈43例(AHI<5),有效46例(AHI降低≥50%),无效26例;有效率为77.4%。结论:通过多平面手术治疗OSAHS,可提高有效率;对于重度患者采用术前气管切开后插管全身麻醉,能有效预防术后严重并发症的发生。
-
关键词:
- 睡眠呼吸暂停低通气综合征 /
- 阻塞性 /
- 悬雍垂腭咽成形术
Abstract: Objective:To evaluate the therapeutic effect of multi-plane operations in treating obstructive sleep apnea-hypopnea syndrome (OSAHS). Method:One hundred and fifteen patients with OSAHS diagnosed by polysomnography were treated with uvuplopalatopharyngoplasty. Eighteen of them were treated combining with nasal septal construction.Twenty six patients also received nasal septal construction and partial inferior turbinectomy. One patients also received Genioglossus advancement and partial resection of corpus linguae. Five patients also received partial resection of corpus linguae. Some patients with the nasal disease and/or the lingual hypertrophy;,AHI>40 and/or BMI>30 are received tracheotomy before general anaesthesia.Result:According to the postoperative follow-up 43 patients,were cured,46 patients were improved, 26 patients were invalid, the effective power was 77.4%.Conclusion:The operative effective power were increased by multi-plane operations in OSAHS patients. The serious complication were prevented through tracheotomy before general anaesthesia in multi-plane operations of severe OSAHS.-
Key words:
- sleep apnea-hypopnea syndrome /
- obstructive /
- uvuplopalatopharyngoplasty
-
[1] 中国肥胖问题工作组数据汇总分析协作组.我国成人体重指数和腰围对相关疾病危险因素异常的检测价值:适宜体重指数和腰围切点的研究[J].中华流行病学杂志, 2002, 23 (1):5-10.
[2] FRIEDMAN M, IBRAHIM H, BASS L.Clinical staging for sleep-disordered breathing[J].Otolaryngol Head Neck Surg, 2002, 127:13-21.
[3] 中华耳鼻咽喉头颈外科杂志编辑委员会, 中华医学会耳鼻咽喉头颈外科学分会咽喉学组.阻塞性睡眠呼吸暂停低通气综合征诊断和外科治疗指南[J].中华耳鼻咽喉科头颈外科杂志, 2009, 44 (2):95-96.
[4] SHEPARD JW J R, THAWLEY S E.Evaluation of the upper airway by computerized tomography in patients undergoing uvulopalatopharyngoplasty for obstructive sleep apnea[J].Am Rev Respir Dis, 1989, 140:711-716.
[5] WHITE D P, YOUNES M K.Obstructive sleep apnea[J].Compr Physiol, 2012, 2:2541-2594.
[6] 叶京英, 韩德民, 王军, 等.计算机辅助纤维喉镜检查预测改良UPPP手术疗效的意义[J].中国耳鼻咽喉头颈外科杂志, 2004, 11 (6):371-375.
[7] HOU J, YAN J, WANG B.Treatment of obstructive sleep apnea-hypopnea syndrome with combined uvulopalatophyngoplasty and midline glossectomy:outcomes from a 5-year study[J].Respir Care, 2012, 7:371-375.
[8] TANYERI H, POLAT S, KIRISOGLU C E.Long-term efficacy of submucosal uvulopalatopharyngoplasty for obstructive sleep apnea syndrome[J].Eur Arch Otorhinolaryngol, 2012, 269:2069-2074.
[9] LIU S R, YI H L, YIN S K.Primary maxillomandibular advancement with concomitant revised uvulopalatopharyngoplasty with uvula preservation for serere obstructive sleep pnea-hypopnea syndrome[J].J Cranifac Surg, 2012, 23:1649-1653.
计量
- 文章访问数: 115
- PDF下载数: 89
- 施引文献: 0