两种等离子术式治疗阻塞性睡眠呼吸暂停低通气综合征的疗效比较研究

目的对全麻下等离子刀打孔消融术＋改良腭咽成形术与局麻下等离子刀打孔消融术治疗阻塞性睡眠呼吸暂停低通气综合征（obstructive sleep apnea hypopnea syndrome,OSAHS）的效果进行比较,寻找一种治疗OSAHS的微创、有效、安全的治疗方式。方法选用A组全麻下等离子刀打孔消融术＋改良腭咽成形术与B组局麻下等离子刀打孔消融术分别对48例和43例OSAHS患者进行治疗,术后随访6个月和12个月,比较两种手术方法的疗效及并发症情况。结果两种术式术后6个月有效率分别为83.3%和60.5%,差异有统计学意义。术后12个月,全麻下等离子刀打孔消融术＋改良腭咽成形术与局麻下等离子刀打孔消融术有效率分别为79.2%和51.2%,差异有统计学意义。两种手术方法均无严重并发症。结论全麻下等离子刀打孔消融术＋改良腭咽成形术与局麻下等离子刀打孔消融术,无论近期与远期效果都明显好于局麻下单纯等离子打孔消融术,且对重度舌根平面阻塞的患者治疗效果优于单纯等离子刀打孔消融术,无严重手术并发症。

Comparative study of efficacy with two plasma operation in the treatment of obstructive sleep apnea hypoventilation syndrome

Objective To compare the results of radiofrequency ablation assisted improved uvulopalat opharyngoplasty（UPPP） under general anesthesia with radiofrequency ablation under local anesthesia in the treatment of obstructive sleep apnea hypopnea syndrome（OSAHS）,looking for a Wicresoft,effective and safe treatment of OSAHS.Methods 48 patients were treated with radiofrequency ablation assisted improved UPPP under general anesthesia in A group,in group B 43 patients with radiofrequency ablation under local anesthesia.They were followed-up for 6 and 12 months after operation and the outcomes of the two surgical methods were compared.Results The improvement rates at 6 months in group A and group B were 83.3% and 60.5% respectively.There was significant difference between the two methods.The improvement rates at 12 months in group A and group B were 79.2% and 51.2% respectively.The difference was significant.No major complication was found.Conculosion The recent and long-term outcome of adiofrequency ablation assisted improved UPPP under general anesthesia is better than that of radiofrequency ablation under local anesthesia,and has advantage in treating the patients in the tongue base of obstruction.