摘要
目的 :术前用纤维鼻咽镜判断阻塞性睡眠呼吸暂停综合征 (OSAS)患者咽腔阻塞部位 ,提高悬雍垂腭咽成形术 (UPPP)疗效。方法 :2 8例OSAS患者术前分别做M櫣ｌｌｅｒ检查和睡眠状态咽腔观察 ,根据阻塞部位的不同 ,将其分为口咽阻塞型、口咽加下咽阻塞型两种类型。通过术前、术后多导睡眠描记图变化比较两型患者的客观疗效。结果 :①M櫣ｌｌｅｒ检查方法 :口咽阻塞型的AHI从 5 2 .7降至 19.7,最低血氧饱和度 (SaO2 )由 63 .1%升至 80 .0 % (均P <0 .0 1) ;口咽加下咽阻塞型的AHI从 5 4.7降至 3 8.6,最低SaO2 由 60 .7%升至 67.0 % (均P >0 .0 5 )。两型手术有效率分别为 68.4%和 2 2 .2 % (P <0 .0 1)。②睡眠咽腔观察法 :口咽阻塞型的AHI从 48.6降至 18.7,最低SaO2 由 65 %升至 80 % (均P <0 .0 1) ;口咽加下咽阻塞型的AHI从 5 9降至 3 4(P <0 .0 1) ,最低SaO2 由 5 9%升至 71% (P <0 .0 5 )。两型手术有效率分别为 73 .3 %和 3 0 .8% (P <0 .0 5 )。结论
Objective:To improve the therapy effect of uvulopalatopharyngoplasty (UPPP) for the obstructive sleep apnea syndrome (OSAS) with the use of sleep pharyngolaryngoscopy and the Müller maneuver to localize pharyngeal airway collapse.Method:Twenty-eight patients with OSAS were divided into two groups respectively based on findings of Müller maneuver and sleep pharyngolaryngoscopy: TypeⅠhad only oropharyngeal(soft palate and palatine tonsil )collapse and type Ⅱhad oropharyngeal collapse with hypopharyngeal collapse. All outcome of PSG after UPPP was analyzed.Result:①In TypeⅠ, the change of the average apnea hypopnea index (AHI) and the lowest SaO _2 before and after UPPP was 52.7 to 19.7(P< 0.01), 63.1% to 80.0%(P< 0.01) using Müller maneuver, and 48.6 to 18.7(P< 0.01), 65% to 80%(P< 0.01)using sleep pharyngolaryngoscopy respectively; In type Ⅱ, the change was respectively 54.7 to 38.6(P> 0.05), 60.7% to 67.0%(P> 0.05)using Müller maneuver, and 59 to 34(P< 0.01), 59% to 71%(P< 0.05)using sleep pharyngolaryngoscopy.②Surgical response rate in typeⅠwas compared with typeⅡ: 68.4% VS 22.2%(P< 0.01) using Müller maneuver and 73.3% VS 30.8% (P< 0.05) using sleep pharyngolaryngoscopy, respectively.Conclusion:Endoscopic pharyngeal assessment of OSAS patients has clinical value for the improvement of UPPP outcome.
出处
《临床耳鼻咽喉科杂志》
CSCD
北大核心
2003年第3期145-146,共2页
Journal of Clinical Otorhinolaryngology
