全长保留悬雍垂腭咽成形术后口咽腔解剖径线变化观察

目的:探讨阻塞性睡眠呼吸暂停低通气综合征(OSAHS)行全长保留悬雍垂腭咽成形术后远期的口咽腔解剖径线的变化。方法:对31例行全长保留悬雍垂腭咽成形术后的OSAHS患者进行随访,并且根据其手术前后口咽腔测量结果进行比较分析,包括:悬雍垂长、悬雍垂基底宽、腭舌弓间距和腭咽弓间距、软腭长度、悬雍垂至咽后壁的间距,此外还有颈围和体质指数。结果:OSAHS患者术后与术前相比较,悬雍垂的长与悬雍垂的基底宽、两侧腭弓(腭咽弓或腭舌弓)间距、软腭的长度、悬雍垂至咽后壁的距离均差异有统计学意义(均P<0.05),而颈围及体质指数均差异无统计学意义(均P>0.05)。结论:全长保留悬雍垂腭咽成形术是解决上气道狭窄,尤其是口咽部狭窄的有效手术方法,可以扩大患者口咽部左右径达到健康人水平。

Study of pharyngeal anatomical diameter in patients with obstructive sleep apnea-hypopnea syndrome before and after uvulopalatopharyngoplasty

Objective:To explore the changes of oropharynx in patients with obstructive sleep apnea-hypopnea syndrome(OSAHS) before and after long-term uvulopalatopharyngoplasty with uvula reserved completely.Method:Thirty-one patients with OSAHS were studied.The following indexes were measured before and after uvulopalatopharyngoplasty:length of uvula, width of uvula base, distance between two-side pillars(DBTP), distance between uvula and posterior pharyngeal wall(DBUP), length of soft palate, perimeter of neck and body mass index(BMI).Result:The postoperative length of uvula, width of uvula base, DBTP, DBUP changed significantly after uvulopalatopharyngoplasty(P<0.05).The postoperative lengh of soft palate was significantly less than that before uvulopalatopharyngoplasty(P<0.05).There was no significance difference in BMI and perimeter of neck between preoperative and posterative patients(P>0.05).Conclusion:The uvulopalatopharyngoplasty with uvula reserved completely is an effective method to solve the airway constriction,especially the oropharynx constriction. Transverse diameter could be enlarged to the length of normal adults.