鼾症手术治疗的远期疗效分析

目的 :探讨鼾症腭咽成形术 (UPPP)的远期疗效。方法 :随访睡眠呼吸暂停综合征 46例行UPPP后的疗效。 46例中男 3 9例 ,女 7例 ,3 2～ 66岁 ,平均 46岁 ,均有睡眠时打鼾、夜间憋气、惊醒、胸闷、白天嗜睡、咽干燥等症状 1～ 40年 ,平均 7.4年。 46例中有高血压史 1 3例。 3 3例局部麻醉 ,1 3例气管插管全身麻醉。 6例同期行鼻中隔矫正术 ,7例同时行下鼻甲骨黏膜下切除术。术后随访 1 2～ 96月 ,平均 3 2月。结果 :46例中 45例 (98% )均在手术后 1～ 3d鼾声消失或减轻 ,憋气、惊醒症状消失。 1例无改善。手术中无并发症。远期随访 40例 (87% ) ,其中呼吸暂停消失 2 3例 (5 7% ) ,好转 1 1例 (2 8% ) ,无好转 6例 (1 5 % )。鼾声消失 1 7例 (4 3 % ) ,好转 1 2例 (3 0 % ) ,无好转 1 1例 (2 7% )。白天嗜睡消失 1 2例 (3 0 % ) ,好转 1 9例 (4 8% ) ,无好转 9例 (2 2 % )。口咽干消失 1 0例(2 5 % ) ,好转 1 8例 (4 5 % ) ,无好转 1 2例 (3 0 % )。症状复发者都在术后 3个月后。随访 5年以上的 8例憋气消失 4例 (5 0 % ) ,好转 4例 (5 0 % ) ,嗜睡消失 5例 (62 % ) ,好转 3例 (3 8% ) ;鼾声消失 5例 (62 % ) ,好转 3例 (3 8% ) ;口咽干消失 3例 (3 8% ) ,好转 4例 (5 0 % ) ,无效 1例 (1 2 % )。 1 3例术前

Long-term effect of uvulopalatopharyngoplasty for snoring

Objective:To evaluate and analyze the long-term result of uvulopalatopharyngoplasty(UPPP) for snoring.Method:46 patients were performed the uvulopalatopharyngoplasty (UPPP) operation and followed up for 12 to 96 months.All of the 39 males and 7 females had snoring,oppressed,awaken and chest distress while sleeping for 1 to 40 years. Among them, 13 had hypertension history, 33 cases were undertaken local anesthesia,13 were undertaken general tracheal intubation anesthesia,6 cases were performed correction of nasal septum simultaneously, and 7 cases were simultaneously performed submucoperiosteous resection of inferior turbinate.Result:40 patients of the target population had replied (of 8 cases had over 5 years). Sleep related breathing disorders had disappeared in 23 cases (57%), improved in 11(28%), unchanged in 6(15%). Snoring disappeared in 17(43%),improved in 12(22%),unchanged in 11(27%). Daytime sleeping disapeared in 12(30%),improved in 19(48%),unchanged in 9(22%). 13 patients had hypertention preoperation,6 cases became nomal postoperation and were kept long-term follow up. 4 cases were discovered narrow in lingual level but not softpalatopharyn level by sleeping analysis and the snoring were over 80dB,and sleep apnea was as long as 50 seconds on occasion, hypoxemia was as low as under 50% semetimes.Conclusion: UPPP is an effective operation in greater part cases. However, objective study by sleeping analysis is helpful in comfirming position of narrow preoperation.