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山东大学学报(医学版)

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悬雍垂腭咽成形术联合鼻部手术治疗OSAHS疗效分析

雷大鹏,潘新良,李学忠,许风雷,刘大昱,张立强   

  1. 山东大学齐鲁医院耳鼻咽喉科, 山东 济南 250012
  • 收稿日期:2007-05-21 修回日期:1900-01-01 出版日期:2007-09-24 发布日期:2007-09-24
  • 通讯作者: 雷大鹏

Effect of UPPP combined with nasal surgery for patients with obstructive sleep apnea-hypopnea syndrome

LEI Da-peng, PAN Xin-liang, LI Xue-zhong, XU Feng-lei, LIU Da-yu, ZHANG Li-qiang   

  1. Department of Otorlaryngology & Head and Neck Surgery, Qilu Hospital of Shandong University, Jinan 250012, Shandong, China
  • Received:2007-05-21 Revised:1900-01-01 Online:2007-09-24 Published:2007-09-24
  • Contact: LEI Da-peng

摘要: 目的:探讨悬雍垂腭咽成形术(uvulopalatopharyngoplasty,UPPP)联合鼻部手术治疗阻塞性睡眠呼吸暂停低通气综合征(obstructive sleep apneahypopnea syndrome, OSAHS)的临床疗效。方法:所有患者术前均行多导睡眠呼吸监测(polysomonography,PSG)确诊,在行UPPP手术同期行鼻中隔偏曲粘膜下切除术18例,双侧下鼻甲粘膜下部分切除术20例,腺样体切除术2例。其中5例重度患者术前先在局麻下行气管切开,然后在全麻下行UPPP和鼻部手术,其中2例患者选择了气管切开后6~7d再行UPPP和鼻部手术。术后随访1~2年。结果:患者均有不同程度的症状减轻,其中症状基本消失者5例,明显减轻者14例,症状缓解者6例。无术后并发症发生,术后6~13d(平均8.3d)拔除了气管套管。结论:UPPP联合鼻中隔偏曲矫正、下鼻甲部分切除术治疗OSAHS可取得良好的手术疗效,对于重度OSAHS患者,行前置性气管切开术,能够有效预防手术并发症的发生。

Abstract: Objective: To evaluate the clinical efficiency of uvulopalatopharyngoplasty(UPPP) combined with sub-mucous resection of the nasal septum or inferior turbinate for patients with obstructive sleep apnea-hypopnea syndrome(OSAHS). Methods: All the patients were diagnosed by polysomonography and treated by UPPP. At the same time, sub-mucous resection of the nasal septum was performed on 18 patients, submucous resection of the bilateral turbinate on 20 patients, and adenoidectomy on 2 patients. All of the nasal surgeries were performed by an endoscope. Prophylactic tracheotomy was performed on 5 severe cases. In another 2 cases tracheotomy were performed about 6-7 days before. All the patients were followed up for 1 to 2 years. Results: Symptoms of all the patients were alleviated to some degree: disappeared in 5 patients, reduced in 14 patients, alleviated in 6 patients. No complications occurred. Patients on whom tracheotomies were performed were decannulated in 6-13 days postoperatively. Conclusion: For OSAHS patients, UPPP combined with sub-mucous resection of nasal septum or inferior turbinate could give a better result. For severe OSAHS patients, prophylactic tracheotomy could avoid surgical complications.

Key words: Sleep apnea, obstructive, Surgical procedures, Uvulopalatopharyngoplasty, Submucous resection of nasal septum, Submucous resection of inferior turbinate

中图分类号: 

  • R762
[1] 张红霞,徐永红,陈莉,龚辉成. 成人阻塞性睡眠呼吸暂停低通气综合征外周血TM、MPO的检测及意义[J]. 山东大学学报(医学版), 2016, 54(12): 67-71.
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