摘要
目的探讨改良悬雍垂腭咽成形术(han-uvulopalatopharyngoplasty,H-UPPP)联合低温等离子舌根射频消融术对阻塞性睡眠呼吸暂停低通气综合征(obstructive sleep apnea hypopnea syndrome,OSAHS)患者血氧饱和度及动脉血氧分压(arterial partial pressure of oxygen,PaO_(2))的影响。方法选取OSAHS患者72例,根据手术方式将其分为H-UPPP手术组(采用单一H-UPPP治疗)和联合手术组(采用H-UPPP联合低温等离子舌根射频消融术治疗),有2例失访,最终70例纳入本研究,其中H-UPPP手术组35例,联合手术组35例;比较两组术前和术后6个月低通气指数(apnea hypopnea index,AHI)、最低血氧饱和度(lowest oxygen saturation,LSaO_(2))、PaO_(2)、动脉血二氧化碳分压(arterial partial pressure of carbon dioxide,PaCO_(2))、用力肺活量、第1秒用力呼气容量、Epworth嗜睡量表(epworth sleepiness scale,ESS)评分及模拟视觉量表(visual analogue scale,VAS)评分,观察两组临床疗效及术后不良反应。结果术后6个月,联合手术组和H-UPPP手术组AHI和PaCO_(2)较术前均降低,LSaO_(2)、PaO_(2)均增加(P均<0.05),联合手术组AHI低于H-UPPP手术组,LSaO_(2)、PaO_(2)高于H-UPPP手术组(P=0.036、0.030、0.001),但组间PaCO_(2)比较差异无统计学意义(P=0.737);联合手术组和H-UPPP手术组用力肺活量、第1秒用力呼气容量较术前均增加(P均<0.05),联合手术组用力肺活量、第1秒用力呼气容量均大于H-UPPP手术组(P均<0.001);两组ESS评分均降低,VAS评分均升高,联合手术组ESS评分低于H-UPPP手术组,VAS评分高于H-UPPP手术组。联合手术组治疗总有效率高于H-UPPP手术组(P=0.025);两组术后并发症总发生率比较,差异均无统计学意义(P=0.353)。结论H-UPPP联合低温等离子舌根射频消融术可有效促进OSAHS患者肺功能恢复,改善LSaO_(2)、PaCO_(2)及PaO_(2),临床疗效较好,安全性较佳。
Objective To explore the effect of han-uvulopalatopharyngoplasty(H-UPPP)combined with radiofrequency ablation of tongue root at low temperature on oxygen saturation and arterial partial pressure of oxygen(PaO_(2))in patients with obstructive sleep apnea hypopnea syndrome(OSAHS).Methods Seventy-two patients with OSAHS were selected.They were divided into H-UPPP operation group(treated with single H-UPPP)and combined operation group(treated with H-UPPP combined with low-temperature plasma radiofrequency ablation of tongue root)according to the operation methods.Two patients were lost to follow-up,and finally 70 patients were included in this study.There were 35 patients in H-UPPP operation group and 35 patients in combined operation group.The apnea hypopnea index(AHI),low est oxygen saturation(LSaO_(2)),PaO_(2),arterial partial pressure of carbon dioxide(PaCO_(2)),forced vital capacity,forced expiratory volume in the first second,Epworth sleepiness scale(ESS)and visual analogue scale(VAS)were compared between the two groups before and 6 months after operation.The clinical efficacy and postoperative adverse reactions of the two groups were observed.Results Six months after operation,AHI and PaCO_(2)in the combined operation group and H-UPPP operation group decreased compared with that before operation,while LSaO_(2)and PaO_(2)increased(all P<0.05).The AHI of combined operation group was lower than that of H-UPPP operation group,and LSaO_(2),PaO_(2)were higher than that of H-UPPP operation group(P=0.036,0.030,0.001).But there was no significant difference in PaCO_(2)between the two groups at six months after operation(P=0.737).The forced vital capacity and forced expiratory volume in the first second in the combined operation group and H-UPPP operation group were higher than those before operation(all P<0.05).The forced vital capacity and forced expiratory volume in the combined operation group were higher than those in the H-UPPP operation group(all P<0.001).The ESS score decreased and the VAS score increased in both groups.The ESS score of combined operation group was lower than that of HUPPP operation group,and the VAS score was higher than that of H-UPPP operation group.The total effective rate of the combined operation group was higher than that of the H-UPPP operation group(P=0.025).There was no significant difference in the total incidence of postoperative complications between the two groups(P=0.353).Conclusion H-UPPP combined with radiofrequency ablation of tongue root with low temperature plasma can effectively promote the recovery of lung function and improve LSaO_(2),PaCO_(2),and PaO_(2)in patients with OSAHS,with good clinical efficacy and safety.
作者
王桂芳
李仁高
马青
WANG Guifang;LI Rengao;MA Qing(Department of Otorhinolaryngology,No.926 Hospital,Joint Logistics Support Force of the People's Liberation Army of China,Kaiyuan 661600,Yunnan,China)
出处
《山东大学耳鼻喉眼学报》
CAS
2024年第3期49-54,共6页
Journal of Otolaryngology and Ophthalmology of Shandong University
关键词
腭咽成形术
射频消融术
舌
阻塞性睡眠呼吸暂停低通气综合征
肺功能
血氧饱和度
动脉血氧分压
Uvulopalatopharyngoplasty
Ablation techniques
Tongue
Obstructive sleep apnea hypopnea syndrome
Lung function
Oxygen saturation
Arterial partial pressure of oxygen
