预防性气管切开术在阻塞性睡眠呼吸暂停综合征中的应用

为预防阻塞性睡眠呼吸暂停综合征（OSAS）行悬雍垂腭咽成形术（UPPP）时的并发症，对32例OSAS患者作预防性气管切开术行UPPP治疗的经验进行总结，UPPP术后，3例出现短暂进食返流，无其它并发症发生，术后10d～2个月，所有患者均拔管顺利，28例疗效明显，4例自觉症状无改善。结果表明有严重缺氧表现；伴有严重的心血管疾病；肥胖、颈粗短的OSAS患者应行预防性气管切开术；气管切开时皮肤-气管切口缘褥式缝合有利于换管；气管切开后行UPPP手术时宜选全麻。

Application of Tracheotomy before Uvulopalatopharyngoplastyin Patients with Severe Obstructive Sleep Apnea Syndrome

In order to minimize the postoperative complications of uvulopalatopharyngoplasty (UPPP) for preventing severe obstructive sleep apnea syndrome (OSAS), the data of 32 patients with severe OSAS undergoing UPPP were analyzed. Three cases got temporary regurgitation after UPPP. Ten days to 2 months after UPPP, all patients except 4 obtained satisfactory therapeutic effects after decannulation. All the patients were decannulated favorably. The results indicated that the indications of preventive tracheotomy before UPPP for the patients with OSAS included severe hypoxia symptoms, severe cardiovascular diseases, obesity, brachyneck and glossohypertrophia. After tracheotomy, general anesthesia should be used when performing UPPP. Modified tracheotomy was safe and convenient for replacement of the trachea cannula.