局麻下两切口行保留悬雍垂的腭咽成形术治疗大扁桃体导致的中度OSAHS

目的探讨在局麻下采用两切口行保留悬雍垂的腭咽成形术治疗大扁桃体导致的中度OSAHS的方法和疗效。方法39例患者均在局麻下采用两切口行保留悬雍垂的腭咽成形术。两切口即每侧仅取一个切口,分别于两侧腭舌弓外上侧,较正常切除扁桃体切口稍偏外上约（0．5±0．2）cm,且与悬雍垂根部两侧软腭腹面传统的倒“U”形切口延续,以每侧仅一个切口一次切开,两侧共两个切口以缩短手术时间、减小操作难度。术后随访包括患者主观症状、咽腔检查及多导睡眠监测（PSG）。结果本组所有患者自觉症状改善明显。术前与术后6个月、12个月PSG监测结果各指标比较,低通气指数（AHI）明显下降,最低血氧饱和度（SaO2）升高显著,均有统计学意义。术后6个月治愈33例,显效4例,有效1例,无效1例;术后12个月治愈32例,显效4例,有效2例,无效1例,总有效率97．4％。无并发症发生。结论对于大扁桃体导致的中度OSAHS患者,用本方法治疗,手术时间减少、患者痛苦减轻,术后恢复较快,效果良好,安全性高,患者经济负担减轻。

Uvula-preserving uvulopalatopharyngoplasty with two incisions under local anesthesia to treat moderate OSAHScaused by large tonsils.

Objective To discuss the method and effects of uvula-preserving uvulopalatopharyngoplasty with two inci- sions under local anesthesia in the treatment of moderate OSAHS caused by large tonsils. Methods Thirty-nine patients were treated by uvula-preserving uvulopalatopharyngoplasty with two incisions under local anesthesia. Two inci- sions meant that there was one incision at each side and the incisions of tonsillectomy would unite with the reversed ＂U＂ incision on the soft palate. So the time could be saved and the difficulties of the operation could be reduced. During the postoperative follow-up, the patients＇ symptoms, pharyngeal cavity and PSG were monitered. Results The symptoms of all the patients in the group were improved obviously. Compared with those before the treatment, AHI and the lowest SaO2 showed significant difference in 6 months and 12 months. Later. 33 cases were cured,including 4 excellence, 1 valid, and 1 invalid case 6 months later. Twelve months later, there were 32 cured cases, including 4 excellence, 2 val- id, and 1 invalid cases. The total efficiency was 97.4%. No complications occurred. Conclusion For the patients who suffer from moderate OSAHS caused by large tonsils, this method demonstrates lots of advantages such as safe pro- cedure, fast recovery, good curative effect, and lowered medical cost.