悬雍垂鄂咽成形术及鼻部手术同时完成治疗阻塞性睡眠呼吸暂停低通气量综合征.docVIP

悬雍垂鄂咽成形术及鼻部手术同时完成治疗阻塞性睡眠呼吸暂停低通气量综合征【摘要】 目的 研究对合并鼻部和口咽部阻塞性睡眠呼吸暂停低通气量综合征,同时完成改良鄂咽成形手术(H-UPPP)和鼻内窥镜手术,探讨一次完成多平面手术对OSAHS患者的治疗方法。方法 32例OSAHS的患者,年龄23~45岁,平均34.3岁,其中男30例,女2例,体重指数为21.8~35.7 kg/m?2,术前睡眠呼吸暂停低通气指数(apnea and hypopnea index,AHI)15.4~39.7次/h,平均25.7次/h,最低血氧饱和度67~87,平均77术前鼻咽镜检查阻塞平面均位于鼻腔和口咽部,舌根和会厌均无狭窄。术前均行CT断层扫描鼻腔和口咽部明确诊断狭窄平面以确定个性化术士,手术全麻鼻腔插管现行鼻内镜手术术后硅胶管压迫支撑,再行H-UPPP手术。结果 术后一周、两个月、六个月复查PTT睡眠监测,32例患者总有效100%。 【关键词】 阻塞性,睡眠呼吸暂停;鼻内镜手术和H-UPPP手术同时完成; 鼻腔硅胶管压迫支撑 Treating obstructive sleep apnea with endoscopic sinus operation and revised uvulopalatopharyngoplasty WANG Hui-qin,XIE Xiu-hua.Department of Otorhinolaryngology,Tongliao Citi Railway Hospital,Tongliao 28000,China 【Abstract】 Objective H-uvulopalatopharyngoplasty(H-UPPP)and endoscopic sinus operation were performed in the meantime for obstructive sleep apnea hypopnea syndrom(OSAHS)patients with both oral pharynx and nasal obstruction.Research the method that performing several planes operations to OSAHS patients in the meantime,result analyzed.Methods 32 suffers of OSAHS,age at 23~45 years old,of the average age was 34.3 years old.The male was among them 30,female 2.Body mass index(BMI)was at 21.8~35.7 kg/m?2.Before the operation apnea and hypopnea index(AHI)was at 15.4~39.7 times per hour,of the average was 25.7 times per hour.The lowest saturation of oxygen in the blood was at 67~87,of the average was 77.The obstrutions were at nasal cavity and oral pharynx planes before the operations,no obstruction at epiglottis and base of the tongue.CT faultage scan was finished before the operations to diagnose the obstructive planes for the individuated operation pattern.Operations were performed under the whole anaesthesia with nasal cavity spile.After the endoscopic sinus operation,opperssing and sustaining the nasal cavity with the tube of silicagel,was H-uvulopalatopharyngoplasty(H-UPPP).Results Occording the result of thecounterchecking PTT dormancy scrutiny at the days of one week,two months and six months af