重度OSAHS并高血压患者行悬雍垂腭咽成形术前后血压变化分析

目的：观察重度阻塞性睡眠呼吸暂停低通气综合征（OSAHS）并高血压患者行悬雍垂腭咽成形术（UPPP）治疗前后血压变化。方法选择重度OSAHS同时合并高血压的患者32例，均有口服降压药3年以上而血压仍控制不佳病史。治疗采用改良UPPP手术，分别于手术前及手术后6个月时行多导睡眠图（PSG）监测和24 h动态血压监测，进行数据对比。结果①改良 UPPP手术6个月后睡眠呼吸暂停低通气指数（AHI）、呼吸暂停指数（AI）、微觉醒指数（MAI）中位数均明显降低（P＜0．05）；平均血氧饱和度（SaO2）和最低血氧饱和度（LSaO2）则明显升高（P＜0．05）；②UPPP术后6个月24 h动态血压监测发现，24 h平均收缩压（SBP）、舒张压（DBP），日间、夜间的平均SBP、DBP均明显降低，与术前比较差异有统计学意义（P＜0．05）。结论行UPPP对于重度OSAHS合并高血压患者的血压控制，效果显著。

Changes of blood pressure in severe OSAHS patients with hypertension before and after Uvulopalatopharyngo-plasty

Objective To investigate changes of blood pressure in the patients with severe obstructive sleep apnea hypopnea syndome（OSAHS）complicated with hypertension between before and after uvulopalatopharyngoplasty （UP-PP）.Methods 32 Patients suffering from severe OSAHS with hypertension were enrolled.All of them have taken oral antihypertensive drugs for more than three years and the blood pressure was poorly controlled.All the 32 patients were treated with modified UPPP.The polysomnograpy（PSG）and 24-hour dynamic blood pressure were monitored before operation and six months after operation.The results were compared.Results ①Six months after modified UPPP, median of apnea/hypopnea index（AHI）/Apnea index（AI）/microarousal index（MAI）were all decreased obviously（ P〈0.05）.The average SaO2 and lowest SaO2 were higher significantly （all P〈0.05）.②Six months after modified UPPP,the 24-hour average systolic blood pressure（SBP）/diastolic blood pressure （DBP）,daily and nightly average SBP/DBP all were decreased obviously（P〈0.05 ）.Conclusion UPPP is good at blood pressure control for the patients with severe OSAHS complicated with hypertension.