改良悬雍垂腭咽成形术治疗阻塞性睡眠呼吸暂停低通气综合征40例临床分析(1)
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[摘要] 目的 了解阻塞性睡眠呼吸暂停低通气综合征(OSAHS)的临床症状和改良悬雍垂腭咽成型术(MUPPP)的方法，探讨临床使用MUPPP治疗OSAHS的疗效，并总结临床使用该方法的经验。 方法 对40例OSAHS患者行MUPPP，然后记录并分析比较其多导睡眠监测的结果，并进行术后疗效评价。 结果 与治疗前相比，患者治疗后6个月、12个月和24个月的呼吸紊乱指数(AHI)、最低血氧饱和度及平均血氧饱和度均存在显著统计学差异(P<0.05)；患者打鼾、憋气、头痛及嗜睡等症状在治疗12个月后明显消失，总有效率为100%。 结论 使用MUPPP对OSAHS进行治疗，能够有效的增大腭咽腔的通气面积，同时保持咽黏膜的正常功能，术后并发症少，临床疗效显著，值得临床予以推广。
[关键词] 改良悬雍垂腭咽成形术；阻塞性睡眠呼吸暂停低通气综合征；打鼾；嗜睡
[中图分类号] R563.9 [文献标识码] B [文章编号] 1673-9701(2012)01-034-02
Modified uvulopalatopharyngoplasty for treatment of obstructive sleep apnea hypopnea syndrome: a clinical analysis of 40 cases
LOU Zhiping GU Xiling
Department of Otolaryngology Head and Neck Surgery, Zhuji People′s Hospital of Zhejiang Province, Zhuji 311800, China
[Abstract] Objective To understand the clinical symptoms of obstructive sleep apneahypopnea syndrome (OSAHS) and the modified uvulopalatopharyngoplasty (MUPPP) . To explore the clinical use of MUPPP for treatment of OSAHS, and summarize the clinical used experience. Methods All 40 cases of OSAHS patients underwent MUPPP. Then recorded and compared the polysomnography results, and evaluated postoperative efficacy. Results Compared with before treatment, AHI, the lowest oxygen saturation and average oxygen saturation had significant statistical difference in posttreatment 6 months, 12 months and 24 months (P<0.05). Patients with snoring, suffocation, headache and lethargy and other symptoms 12 months after treatment apparently disappeared, and the total efficiency was 100%. Conclusion The use of MUPPP for treatment of OSAHS could effectively increase the velopharyngeal cavity ventilation area, keep the normal function of the pharyngeal mucosa, less complications, obvious curative effect, and worthy of clinical popularization.
[Key words] Uvulopalatopharyngoplasty; Obstructive sleep apnea hypopnea syndrome; Snoring; Sleepiness
阻塞性睡眠呼吸暂停低通气综合征(obstructive sleep apneahypopnea syndrome，OSAHS)在临床被认为是尚不明确病因且复杂的疾病。因为睡眠中呼吸调节不规律，病理临床上表现为睡眠中打鼾，并且于日间出现嗜睡现象，且因为呼吸暂停与低通气引发反复低氧高碳酸血症，致使心肺与身体重要器官出现并发症，甚至发生猝死，因此OSAHS是一种有潜在致死性的睡眠呼吸紊乱性疾病[1]。在临床上，悬雍垂腭咽成形术(uvulopalatopharyngoplasty，UPPP)是治疗阻塞性睡眠呼吸暂停低通气综合征的手术之一 ......
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