舌骨悬吊手术的并发症

目的探讨对重度阻塞性呼吸暂停低通气综合征(OSAHS)患者行悬雍垂腭咽成形术(UPPP)联合舌骨悬吊术时引起的并发症。方法对重度OSAHS患者行UPPP联合舌骨悬吊术109例,每例患者术前均行清醒状态纤维喉镜下Muller检查、上气道的X线片或上气道CT测量,术前确定阻塞平面为腭-咽及舌-咽平面,但以舌-咽平面为主,均行UPPP联合舌骨悬吊术,术后均于ICU保留气管插管监护1～2 d。结果1例患者术中下颌骨下缘打孔过于偏下,穿线打结后丝线将下颌骨打孔处下缘撕裂;6例患者术后颈部切口出现脂肪液化;3例患者颏部切口反复红肿,考虑缝线局部刺激;2例患者术后出现颈部切口出血。所有患者在开始进食时有咽部、舌部不适,手术2～4 d后舌体运动略有受限,一般在5～7 d后舌体运动感觉正常。结论舌骨悬吊术的并发症较少,解除重度OSAHS患者的舌-咽平面的狭窄不失为一种简单、安全、有效的方法。

Complications following hyoid suspension

Objective To explore the complications that happened after uvulopalatopharyngoplasty(UPPP) combined with hyoid suspension for obstructive sleep apnea hyperventilate syndrome(OSAHS) patients.Methods From January 2003 to June 2008,109(98 males and 11 females) cases of severe OSAHS were treated with UPPP.All patients were checked with a fiber optic laryngoscope of Muller and Xray or CT for upper air flue when they were in a waking state to locate the collapse level(oropharyngeal and palatopharyngeal level,most of them had an obstruction on the oropharyngeal level).After the UPPP,they were sent to the ICU and monitored with trachea cannula for 1 to 2days.Results The lower perforated edge of the inferior maxilla mangled by the thread for the hole was too low in 1 case.Incisions on the neck were fat liquoring in 6 cases.3 cases had repeated inflammation,which was probably because the incision was irritated by the suture.2 cases had bleeding from the incision.All had discomfort sensation on the pharyngeal and glossal portion,and movement of the tongue was constrained for 2-4 days and became normal after 5-7days.Conclusion Hyoid suspension has few complications and is simple,safe and effective for OSAHS with an oropharyngeal level collapse.