阻塞性睡眠呼吸暂停低通气综合征患者气管切开术

目的探讨气管切开术作为一种治疗方法在阻塞性睡眠呼吸暂停低通气综合征患者气管切开术(obstructive sleep apnea hypopnea syndrome,OSAHS)治疗中的应用。方法OSAHS患者行气管切开术4例。预防性的气管切开2例,1例为悬雍垂腭咽成形术(uvulopalatophar yngoplasty,UPPP)和颏舌肌前移舌骨悬吊术治疗(GAHM)术后的预防性气管切开,1例为UPPP术前的预防性气管切开,2例为永久性气管切开手术。预防性的气管切开采用常规气管切开方法,永久性气管切开采用Fee和Warld的永久性气管切开术,并对相关文献进行了复习。结果预防性的气管切开能降低重度OSAHS患者UPPP、GAHM等手术的术后风险,永久性气管切开术对极重度OSAHS患者是一种挽救性手术。结论气管切开术作为一种有效的治疗OSAHS的方法,对于一些极重度阻塞性睡眠呼吸暂停低通气综合征患者有不可替代的作用。

The application of tracheotomy for obstructive sleep apnea hypopnea syndrome

OBJECTIVE To evaluate the application of tracheotomy for obstructive sleep apnea hypopnea syndrome (OSAHS). METHODS Two cases underwent prophylactic tracheotomy with routine method. One case was performed after UPPP and GAHM, another before UPPP. The permanent tracheotomy was performed in 2 severe OSAHS cases with Fee and Ward methods. In addition, the literatures about this approach were reviewed. RESULTS Four cases had been achieved fine clinical outcome. The prophylactic tracheotomy can reduce the risk of the UPPP and GAHM. Permanent tracheotomy is a remedy operation to the severe cases. CONCLUSION Tracheotomy is an effective alternative for management of OSAHS. Nothing could substitute tracheotomy for OSAHS in some severe cases.