体位性与非体位性OSAHS患者接受低温等离子辅助UPPP疗效观察

摘要

目的 探讨低温等离子辅助悬雍垂腭咽成形术(UPPP)对体位性和非体位性阻塞性睡眠呼吸暂停低通气综合征(OSAHS)患者的治疗效果.方法 选择该院2014年1月至2015年12月经多导睡眠呼吸监测(PSG)确诊为OSAHS并接受低温等离子辅助UPPP的患者26例,根据不同睡眠体位状态下呼吸暂停低通气指数(AHI)将OSAHS患者分为体位性睡眠呼吸暂停(PPs)组、非体位性睡眠呼吸暂停(NPPs)组,比较两组患者手术前、后AHI变化及手术有效率.结果 PPs组总AHI、仰卧位AHI(S-AHI)、侧卧位AHI(L-AHI)均低于NPPs组(P＜0.05),且血氧相关指标高于NPPs组(P＜0.05);OSAHS患者手术总有效率为73.08％ (19/26),其中PPs组手术有效率为100％(7/7),NPPs组手术有效率为63.16％(12/19),但两组患者手术有效率比较差异无统计学意义(P=0.13).与手术前比较,两组患者手术后总AHI、S-AHI、L-AHI均下降(P＜0.05);NPPs组L-AHI下降幅度明显高于S-AHI[0.96(0.86,1.00)vs.0.53(0.34,0.77),P＜0.01].NPPs组中术后有78.95％(15/19)转变为PPs.结论 低温等离子辅助UPPP治疗对OSAHS患者有一定治疗效果,其中NPPs患者受益更明显.%Objective To investigate the curative effect of low-temperature plasma-assisted uvulopalatopharyngoplasty(UP-PP)in the patients with positional and non-positional obstructive sleep apnea-hypopnea syndrome(OSAHS).Methods Twenty-six patients with OSAHS diagnosed by polysomnography monitoring receiving the low-temperature plasma-assisted UPPP in our hospital from January 2014 to December 2015 were selected and divided into the positional OSAHS group(PPs) and non-positional OSAHS group(NPPs) according to the apnea-hypopnea index (AHI) under different sleep positional status.The AHI change before and after operation and operation effective rate were compared between the two groups.Results Theoverall AHI,supine position AHI and lateral position AHI in the PPs group all were lower than those in the NPPs group(P＜0.05),moreover the blood oxygen related indexes were higher than those in the NPPs group(P＜0.05).The overall surgical effective rate in the OSAHS patients was 73.08％ (19/26),in which the surgical effective rate was 100％ (7/7) in the PPs group and 63.16％ (12/19) in the NPPs group,the difference between the two groups had no statistical significance(P=0.13).The postoperative total AHI,supine position AHI and lateral position AHI in the two groups were decreased compared with before operation(P＜0.05);the decrease range of lateral position AHI in the NPPs group was significantly higher than that in the supine position AHI[0.96(0.86,1.00)vs.0.53(0.34,0.77),P＜0.01].78.95 ％ (15/19) postoperation patients in the NPPs group converted to PPs.Conclusion Low-temperature plasma-assisted UPPP has some effects on OSAHS patients,in which the benefit of NPPs are more apparent.