单纯扁桃体切除术对于成人FriedmanⅠ型阻塞性睡 .doc

单纯扁桃体切除术治疗成人FriedmanⅠ型阻塞性睡眠呼吸暂停低通气综合征患者的安全性谭祖林，郭睿，王戈 （北京空军总医院耳鼻咽喉头颈外科，?北京 100142） 【摘要】目的 观察单纯扁桃体切除术治疗成人FriedmanⅠ型阻塞性睡眠呼吸暂停低通气综合征（OSAHS）患者的临床效果。方法 选取2007年2月至2014年6月在我院耳鼻咽喉头颈外科治疗的FriedmanⅠ型OSAHS患者119例，其中行单纯扁桃体切除术51例（观察组），行悬雍垂腭咽成形术（UPPP）68例（UPPP组），比较两组患者的手术时间、住院天数、术后1 d咽部疼痛视觉模拟量表（VAS）评分、Epworth嗜睡评分、多导睡眠监测（PSG）指标、治疗疗效等。结果 观察组患者手术时间和住院天数分别为（25.73±2.58）min和（5.46±1.53）d，明显短于UPPP组，差异均有统计学意义（P＜0.05）；观察组术后VAS评分为（9.13±1.71）分，明显高于UPPP组，差异有统计学意义（P＜0.05）；观察组治疗总有效率为84.31%，UPPP组为80.88%，两组疗效比较差异无统计学意义（P＞0.05）；观察组和UPPP组治疗前、治疗后两组间的体质量指数（BMI）、呼吸暂停低通气指数（AHI）、血氧饱和度（SaO2）和Epworth评分比较差异均无统计学意义（P＞0.05）；两组治疗后AHI和Epworth评分均较本组治疗前有所降低（P＜0.05），而SaO2较治疗前升高（P＜0.05）；观察组术后咽部不适比例为11.76%，低于UPPP组的25.00%，差异有统计学意义（P＜0.05）。结论 单纯扁桃体切除术治疗成人FriedmanⅠ型OSAHS疗效确切，更为简便、安全、易行，是一种有效的手术方式。 【关键词】FriedmanⅠ型；阻塞性睡眠呼吸暂停低通气综合征；扁桃体切除术；悬雍垂腭咽成形术；疗效 Clinical effect of tonsillectomy in the treatment of adult FriedmanⅠtype obstructive sleep apnea hypopnea syndrome. TAN Zu-lin, GUO Rui, WANG Ge. Department of Otorhinolaryngology, Head and Neck Surgery, Air Force General Hospital, PLA, Beijing 100142, CHINA 【Abstract】Objective To investigate the clinical effect of tonsillectomy in the treatment of adult FriedmanⅠtype obstructive sleep apnea hypopnea syndrome (OSAHS). Methods A total of 119 patients of FriedmanⅠOSAHS in our hospital from February 2007 to June 2014 were selected, of which 51 patients undergone tonsillectomy were enrolled as the observation group, and 68 patients undergone uvulopalatopharyngoplasty (UPPP) were enrolled as UPPP group. The operation duration, length of hospital stay, VAS score for pharyngeal pain 1 d after operation, Epworth sleepiness score and multichannel sleep monitor (PSG), clinical effect were compared between the two groups. Results The operation duration and length of hospital stay were (25.73±2.58) min and (5.46±1.53) d in the observation group, which were significantly shorter than those in the UPPP group (P0.05). The postoperative VAS score in the observation group was (9.13±1.7