多平面手术对阻塞性睡眠呼吸暂停低通气综合征患者吞咽生活质量的影响

目的 评价上气道多平面手术对阻塞性睡眠呼吸暂停低通气综合（obstructive sleep apnea hypopnea syndrome，OSAHS）患者吞咽相关生活质量的影响。方法 应用SWAL-QOL吞咽量表对68例OSAHS患者手术前及术后进行问卷调查。根据是否行舌根手术，将患者分为腭部手术组29例和腭部与舌后区联合手术的多平面手术组39例，比较两组患者手术前后吞咽相关生活质量的变化。结果 腭部手术组术后在进食时间、症状频率维度生活质量较术前差（P<0.01）；多平面手术组在心理负担、进食时间、症状频率、语言交流、心理健康及社会交往等维度术后较术前差（P<0.05～0.01）；两组术后得分比较，在心理负担、进食时间、症状频率、语言交流、心理健康及社会交往等维度，多平面手术组较腭部手术组差（P<0.05～0.01）。结论 上气道多平面手术对OSAHS患者术后吞咽相关生活质量有一定影响。

Effect of upper airway multi-level surgeries on the swallowing-related quality of life in patients with obstructive sleep apnea hypopnea syndrome

Objective To explore the effects of upper airway multi-level surgeries on the swallowing-related quality of life in patients with obstructive sleep apnea hypopnea syndrome(OSAHS). Methods The SWAL-QOL questionnaire was given to 68 OSAHS patients before and 6-17 months after surgeries. Depending on whether the tongue base operations were done, the patients were divided into two groups：the multi-level operation group(n=39) and the retropalatal operation group(n=29). The swallowing-related quality of life was evaluated before and after the operations. Results Velopharyngeal insufficiency occurred in 31 patients(45.59％),choking when eating or drinking in 13 (19.1％),eating slower than normal in 14 (20.6％) and double swallows or needing great efforts in 5 (7.35％). The retropalatal operation group had significant differences before and after surgeries in eating duration and symptom frequency dimentions (P<0.01). The multi-level operation group had lower scores in berden（P=0.041）, eating duration（P=0.002）, symptom frequency（P=0.000）,　communication （P=0.007）, mental health （P=0.000）and social interaction（P=0.041） after surgeries than before surgeries. Following the operations, the scores of the multi-level operation group alsowere lower than the retropalatal operation group in berden（P=0.047）, eating duration（P=0.016）, symptom frequency（P=0.016）, communication（P=0.010）, mental health（P=0.047）and social interaction（P=0.047）. Conclusion Upper airway multi-level surgeries have negative effects on the swallowing-related quality of life.