等离子辅助手术治疗重度OSAHS患者生活质量的主客观评估

【摘要】 目的评估低温等离子辅助改良悬雍垂腭咽成形术（H-UPPP）+舌根淋巴组织切除术+舌体打孔消融术（CCT）联合治疗重度阻塞性睡眠呼吸暂停低通气综合征（OSAHS）患者生活质量的改善程度，并与单纯行H-UPPP手术疗效进行比较。方法重度OSAHS患者81例，其中治疗组42例采用低温等离子辅助H-UPPP+舌根淋巴组织切除术+CCT治疗，对照组39例行H-UPPP手术，记录2组患者术前及术后6个月的睡眠呼吸暂停低通气指数（AHI）、最低血氧饱和度（LSaO2），采用魁北克睡眠问卷（QSQ）和Epworth嗜睡量表（ESS）评估患者生活质量并进行比较。结果 治疗组患者术后各项指标较术前均有明显改善（P < 0.01），手术总有效率优于对照组（83.3% vs 12.8%，χ2=40.225，P＜0.01）。治疗组QSQ中白天嗜睡（76.2% vs 25.6%）、夜间症状（54.8% vs 5.1%）、白天症状（71.4% vs 10.2%）、情绪（54.8% vs 2.5%）及社会交往（50.0% vs 2.5%）5个维度以及总分（57.1% vs 7.7%）的术后总改善率均优于对照组；治疗组术后ESS中重度的比例下降至23.8%，优于对照组的51.3%。结论 采用低温等离子辅助H-UPPP+舌根淋巴组织切除术+CCT治疗重度OSAHS可取得较好的疗效，患者的生活质量也能得到明显改善。

Subjective and Objective Assessment of Quality of Life for Coblation-assisting Operation in Patients with Severe OSAHS

[Abstract]ObjectiveTo evaluate the subjective and objective improvement of quality of life in patients with lowtemperature plasma- assisted modified uvulopalatopharyngoplasty (H- UPPP) combined with lymphoidectomy in radix lin?guae and coblation-channeling of the tongue(CCT) treating for severe obstructive sleep apnea hypopnea syndrome (OSAHS)，and compare the surgical efficacy with that of H-UPPP.MethodsA total of81patients with severe OSAHS were divided into treatment group (n=42) and control group (n=39). Treatment group underwent the low-temperature plasma-assisted HUPPP combining lymphoidectomy in radix linguae and CCT，and control group underwent H-UPPP treatment. The apnea hypopnea index (AHI), the lowest saturation of arterial oxygen (LSaO2) and Quebec sleep questionnaire (QSQ) and Epworthsleepiness scale (ESS) before operation and6-month after operation were recorded and compared between two groups.Results All of detection indicators were significantly improved after operation in treatment group (P<0.01). The total surgicalefficacy was significantly higher in treatment group than that of control group (83.3%vs12.8%，χ2=40.225，P＜0.01). The total improvement rate of five dimensions in QSQ such as daytime sleepiness symptoms (76.2%vs25.6%), signs during the day(71.4%vs10.2%) and night (54.8%vs5.1%), emotion (54.8%vs2.5%), ability of social intercourse (50.0%vs2.5%) and thetotal score (57.1%vs7.7%) after operation were significantly higher in treatment group than those of control group. The severe indexes of ESS decreased to23.8% after operation in treatment group than those of control group (51.3%).ConclusionLow-temperature plasma-assisted H-UPPP combined with lymphoidectomy in radix linguae and CCT is effective in patients with severe OSAHS, which can also improve the quality of life postoperatively.