同期多平面手术对重度阻塞性睡眠呼吸暂停综合征患者生活质量的影响

目的评价同期多平面手术（鼻腔扩容术和腭咽成形术）对重度阻塞性睡眠呼吸暂停综合征（OS—AHS）患者生活质量（QOL）的影响。方法50例患者经多导睡眠图（PSG）监测确诊为重度0SAHS，术前进行明确的阻塞平面定位，均为多平面阻塞，根据阻塞平面的不同采取相应的手术方法进行治疗。均采取气管插管全身麻醉下同期行鼻腔扩容术、改良腭垂腭咽成形术及颏舌肌前移舌骨悬吊术。术前和术后12个月分别进行Epworth睡眠量表（Epworth sleepiness scale，ESS）及睡眠呼吸暂停生活质量指数（Sleepapnea quality of life index．SAQLI）评分，将所获资料进行统计学分析。结果OSHAS患者术前ESS评分与sAQu总分及各项评分之间存在显著相关性。术后患者多导睡眠监测参数、ESS和SAQLI评分及其余各项指标均有明显改善（P〈0．05），手术治疗总有效率为96％，QOL总体改善率为74％。患者术后均未出现严重并发症，无需行气管切开术。结论根据阻塞平面进行同期多平面手术可有效改善重度0S—HAS患者的QOL，同期多平面手术治疗重度OSAHS安全有效。

THE EFFECT OF THE SAME TERM MULTIPLE PLANE OPERATIONS ON THE LIFE QUALITY OF THE SEVERE OBSTRUCTIVE SLEEP APNEA - HYPOPNEA SYNDROME PATIENTS

Objective To evaluate the effect of the same term multiple plane operations （nasal cavity enlarging surgery and palatopharyngoplasty） on the life quality of the severe obstructive sleep apnea - hypopnea syndrome patients. Methods Totally 50 patients were diagnosed severe obstructive sleep apnea- hypopnea syndrome by polysomnography （PSG） and multiple plane obstructive before the surgery. They were given corresponding surgery aim at different obstructive plane. All patients were given nasal cavity enlarging sur- gery and palatopharyngoplasty, Genioglossus advancement and hyoid suspension surgery under general an- esthesia through trachea cannula. We gave a mark to all patients through epworth sleepiness seale（ESS） and sleep apnea quality of life index（SAQLI） at pre- operation and 12 months after operation. Results There was remarkable correlation between the pre- operation ESS score and the SAQLI score. The score of ESS and SAQLI and other indexes were all improved obviously（P~0. 05）, the total effective rate of surgery was 95.56%, the total improvement rate of QOL was 77.8%. No serious complications and tracheotomy occur in all patients. Conclusion The same term multiple plane operations based on the obstructive plane can improve OSHAS patients QOL effectively and it is safe to serious OSHAS patients.