同期行改良悬雍垂腭咽成形术和鼻中隔成形术治疗阻塞性睡眠呼吸暂停低通气综合征的可行性

摘要

Objective To explore the feasibility and therapeutic effect of single-staged Han-uvulopalatopharyngoplasty with septoplasty in adults with obstructive sleep apnea-hypopnea syndrome.Methods Ninety six cases with OSAHS were diagnosed by polysomnography, and they all had retropalatal obstruction and deviation of nasal septum.Patients were divided into study group(48 cases) and control group(48 cases) randomly.Cases in study group were simultaneously treated with Han-uvulopalatopharyngoplasty and septoplasty, while cases in control group were only treated with Han-uvulopalatopharyngoplasty.U saturation skill and coblation-assisted were applied in Han-uvulopalatopharyngoplasty.And nasal septum suture technique was applied in septoplasty.The observation index included the intranasal changes with acoustic rhinometry, the prevalence of common postoperation complications and curative effects after six months follow-up period.SPSS 18.0 was used for statistical analysis.Results In study group the overall response rate was 83.33%(40/48), while in control group the overall response rate was 62.50%(30/48).There was statistical significance of response rate between test group and control group(x2=5.275, P<0.05).There was no statistical significance on complication rate between study group and control group(P>0.05).There was no statistical significance on preoperative measurement data(P>0.05).Conclusion For OSAHS patients with obstructive level at retropalatal plane and nasal plane, Han-uvulopalatopharyngoplasty combined with septoplasty in one stage is safe and effective.%目的 探讨同期行改良悬雍垂腭咽成形术(H-UPPP)联合鼻中隔成形术治疗阻塞性睡眠呼吸暂停低通气综合征(OSAHS)的可行性及疗效. 方法 经多道睡眠图监测确诊的OSAHS 96例患者均有腭咽部狭窄和鼻中隔偏曲,根据患者入院顺序分为试验组和对照组,各48例.试验组除行H-UPPP外,同期行鼻中隔成形术,对照组仅行H-UPPP.术式特点:H-UPPP手术应用低温等离子及U缝合技术,鼻中隔成形术中应用鼻中隔缝合技术.观察两组术后鼻声反射测量值变化及常见并发症发生情况,并随访6个月,观察两组疗效.应用SPSS 18.0进行统计学分析.结果 试验组有效以上疗效者40例,总有效率83.33%,对照组有效以上疗效者30例,总有效率62.50%,经比较差异有统计学意义(x2=5.275,P<0.05).两组并发症发生率经比较差异无统计学意义(P>0.05).两组术前各相关测量数据经统计学检验,差异无统计学意义(P>0.05).结论 对同时存在腭咽部狭窄和鼻中隔偏曲的OSAHS患者,可同期行H-UPPP和鼻中隔成形术,且安全有效.