可控射频消融辅助上气道手术治疗阻塞性睡眠呼吸暂停低通气综合征

目的：探讨可控射频消融辅助上气道手术（CAUP）对阻塞性睡眠呼吸暂停低通气综合征（OSAHS）患者上气道全方位进行手术治疗的应用价值。方法：根据术前定位诊断的结果，对168例OSAHS患者上气道不同部位如下鼻甲、软腭、悬雍垂、扁桃体、舌根和舌体等组织进行射频组织减容（RFVTR）治疗的同时，实施腭咽肌切开术，扩大软腭后气道。术后6个月和1年用PSG随访。结果：全部168例患者顺利接受CAUP治疗，有效病例术后打鼾、憋气、口干和困乏等症状消失或明显好转，吞咽、语言和保护功能无明显障碍，主要并发症有咽部异物感和鼻出血。术后PSG随访资料完整者52例，综合疗效评价：治愈14例（26．9％），显效31例（59．6％），有效4例（7．7％），无效3例（5．8％）。结论：RFVTR是一种新兴的微创技术，该方法操作便捷、安全、痛苦小、可重复、简化术后护理、恢复速度快、患者容易接受；RFVTR结合腭咽肌切开术构成一个新的CAUP治疗体系，可以对OSAHS患者进行有效的治疗，是一种值得进一步开发和临床推广应用的新技术。

Application of coblation assisted upper-airway procedure to obstructive sleep apnea-hypopnea syndrome

Objective:To investigate the efficacy and the value of CAUP in treatment of OSAHS.Method:CAUP and the dissection of palatopharyngeus muscle were performed by RFVTR .One hundred and sixty-eight patients with OSAHS treated by CAUP from July 2001 to July 2004 were summarized. Among them, 52 patients were analyzed by PSG after 1 year of the operation.Result:All the operative procedure were carried out smoothly with excellent patient tolerance. Post-operation complications were foreign body feeling in oral cavity. No velopalatal insufficiency occurred. The efficient rate was 94.2% after 1 year of the operation according to the PSG results.Conclusion:CAUP is a simple, safe,repeatable and acceptable surgical procedure and it was developing with excellent value in the treatment of OSAHS on the basic of accurate X-ray imaging.