阻塞性睡眠呼吸暂停低通气综合征患者行UPPP后疗效分析

目的：进一步探讨阻塞性睡眠呼吸暂停低通气综合征（OSAHS）患者行UPPP的疗效，以及UPPP软腭切除范围、OSAHS患者低氧血症术后改善的客观标准。方法：对27例正常成人（正常组）及34例OSAHS患者（OSAHS组）术前、术后15-20d进行腭咽部解剖测量及血常规检查。对术前、术后资料进行统计学分析。结果：正常组与OSAHS组的软腭长、咽侧距、腭侧距、红细胞（RBC）、血红蛋白（HGB）及红细胞比积（HCT）比较，均差异有统计学意义（均P〈0．01）。OSAHS组术后RBC、HGB、HCT的值明显低于术前（均P〈0．01）。OSAHS组仅HGB与最低血氧饱和度（SaO2）有明显的负相关性（r=0．5800，P〈0．01）。术后6个月按主观症状改善显效率为74．2％，总有效率为96．8％，其中改善最明显的症状为白天嗜睡，1例术后鼻咽返流。术后随访6个月。结论：OSAHS术后改善最明显的症状是白天嗜睡，重度OSAHS患者需综合治疗。软腭切除范围不能超过1．5cm；HGB可初步作为评定OSAHS低氧血症及术后血氧饱合度改善的一个客观指标。

Efficacy of postoperation and the change of red blood cell/hemoglobin in patients with obstructive sleep apnea-hypopnea syndrome

Objective:In order to investigate the effect of UPPP in patients with OSAHS,the range of the soft palate excision and impersonality standard for improving low oxygen after UPPP.Method:A prospective study was designed to evaluate 34 adult patients with OSAHS and 27 adult ear patients who were not OSAHS.Blood routine and palatopharyngeal data in two groups were measured before operation and 15~20 days after operation.And fellow up 6 months.The data before and after operation were analysed in statistical method(t test).Result:Length of softpalate,distance of pharynx,distance of palatopharyx,red blood cell(RBC),hemoglobin(HGB), and hematocrit(HCT) were significantly different in normal and OSAHS group(independent t test,P<0.01).Their indexes were significantly different in OSAHS group before and after operation(paired-sample t test,P<0.01).Only HGB and the lowest SaO2 were negative correlation before operation in OSAHS group.The value is bigger for HGB and smaller for SaO2(t test,P<0.01).Result of follow up 6 months(31 cases): The effective ratio of subjective improving was 74.2%,and the total effective ratio was 96.8%.One case had reflux of nasopharynx.Conclusion:Severe OSAHS patients should be undewent synthesized treatment.It is daytime sleepiness that was improved the most obviously.Softpalate excision scope can't exceed 1.5 cm.HGB can be an impersonality index to assess hypoxemia and improvement of SaO2 after operation for OSAHS.