悬雍垂腭咽成形术治疗阻塞性睡眠呼吸暂停综合征

目的探讨提高阻塞性睡眠呼吸暂停低通气综合征(OSAHS)手术疗效的方法.方法OSAHS患者30例,19例全麻下及11例局麻下完成悬雍垂腭咽成形术(UPPP),其中3例行预防性气管切开术.结果术后随访半年,结果治愈6例(20%),显效12例(40%),有效6例(20%),无效6例(20%),总有效率为80%.术中出现呼吸障碍2例,术后扁桃体出血1例,暂时性腭咽功能不全6例.结论悬雍垂腭咽成形术麻醉方法的正确选择、术前预防性气管切开的应用,有助于提高手术疗效,减少并发症的发生.同时,阻塞部位的术前准确定位及手术方案设计、手术技巧也是重要因素.

An investigation on the factors associated with the therapeutic effects of uvulopalatopharyngoplasty for the treatment of obstructive sleep apnea hypopnea syndrome

Objective To investigate the implications of associated factors with the therapeutic effects of uvulopalatopharyngoplasty (UPPP) in the treatment of obstructive sleep apnea hypopnea syndrome(OSAHS)in order to improve the outcome of this procedure. Methods 30 cases with OSAHS were included in this study, all being diagnosed on the basis of oplysomnography and treated by UPPP,Among these cases, 19 were operated on under general anesthesia and 11 were with local anesthesia. Furthermore, 3 of them were given preventive tracheotomy. Results By the end of a following up period lasted for 6 months,an evaluation on the therapeutic effects indicated that 6 cases (20%) were cured, 12 (40%) were significantly effective, 6 (20%) improved and 6(20%) ineffective, with a total effective rate of 80%. Moreover, 2 cases showed respiratory dysfunction in the operating duration,and 1 accompanied with tonsillar bleeding and 6 with shortly lasted incomplete palate function after the operation. Conclusions More important are the decision on the selection of anesthesia procedure and on the application of preventive tracheotomy before operation to improve the therapeutic effects of the treating procedures and to reduce the risk with the operation. Meanwhile, determination on the obstructive location of this lesion, designation on the operating program for each case and preparation of operating technique before operation are also very important factors involving in the therapeutic effects.