中国阻塞性睡眠呼吸暂停低通气综合征治疗回顾

目的评价我国阻塞性睡眠呼吸暂停低通气综合征(obstructivesleepapneahypopneasyndrome,OSAHS)的治疗工作。方法对1995年1月到2004年12月共10年间国内发表的有关OSAHS治疗研究的论著进行回顾性分析。结果10年间国内发表有关OSAHS治疗方面的论著201篇,文献数量逐年增加,其中回顾性病例分析文章占绝大多数,疗效评价标准不统一导致报告的治疗有效率差别明显;相同疗效评价标准下,远期疗效低于近期疗效;多部位手术疗效明显好于单纯悬雍垂腭咽成形术(uvulopalatopharyngo-plasty,UPPP)疗效。结论今后应在中华医学会制定的OSAHS诊断治疗指南的指导下,统一疗效评价标准,开展多中心、大样本的随机对照试验(randomizedcontrolledtrials,RCT),研究并推广上呼吸道解剖性狭窄和上呼吸道咽壁易塌陷性增强的客观评估方法,对不同的情况采用不同的治疗措施,使我国OSAHS治疗工作达到一个新的水平。

Retrospective analysis of the therapeutic studies on obstructive sleep apnea-hypopnea syndrome in the past ten years in our country

OBJECTIVE To summarize and evaluate the therapeutic studies on obstructive sleep apnea-hypopnea syndrome(OSAHS)in our country. METHODS Articles of therapeutic studies on OSAHS published in major journals of our country from Jan. 1995 to Dec. 2004 were evaluated retrospectively. RESULTS A total of 201 articles were recruited. The number of articles published every year was increased with time and most of the articles were retrospective study. There were no standard criteria for evaluating the curative effect,and the cure rate of UPPP were obviously different according to different evaluation criteria. In same evaluation criteria,the short- term outcome were better than long-term outcome,and the patients underwent multiple levels surgery had better outcome than single UPPP. CONCLUSION Multi-center,large sampled and prospective random comparison therapeutic study based on evaluative criteria constituted by Chinese Medical Association should be carried out in the future study. The impersonal methods and criteria for evaluation the upper airway anatomic structure and pharyngeal wall resilience should be established. Individuality therapy should be done. And finally, bring on therapeutic effect of OSAHS to a higher level in our country.