中华耳鼻咽喉头颈外科杂志
中華耳鼻嚥喉頭頸外科雜誌
중화이비인후두경외과잡지
CHINESE JOURNAL OF OTORHINOLARYNGOLOGY HEAD AND NECK SURGERY
2015年
8期
657-660
,共4页
王宇%刘至玄%王效军%张颖%李志杰%曹云%苏海英
王宇%劉至玄%王效軍%張穎%李誌傑%曹雲%囌海英
왕우%류지현%왕효군%장영%리지걸%조운%소해영
睡眠呼吸暂停,阻塞性%舌切除术%耳鼻喉外科手术
睡眠呼吸暫停,阻塞性%舌切除術%耳鼻喉外科手術
수면호흡잠정,조새성%설절제술%이비후외과수술
Sleep apnea,obstructive%Glossectomy%Otorhinolaryngologic surgical procedures
目的 探讨颈外进路舌根部分切除术联合腭咽成形术治疗因舌咽平面狭窄导致阻塞性睡眠呼吸暂停低通气综合征(OSAHS)患者的手术方法及疗效.方法 2012年3月至2013年7月对44例舌咽平面狭窄的重度OSAHS患者行颈外进路舌根部分切除术联合悬雍垂腭咽成形术,术前及术后行上气道CT等相关检查,分析44例患者手术前后的疗效及各种参数的变化情况.结果 44例患者手术后半年呼吸暂停低通气指数(AHI,(-x)±s,下同)由(67.5±21.1)次/h降低至(10.5±6.8)次/h,差异有统计学意义(t=2.1,P＜0.01);最低血氧饱和度由0.694±0.009提高至0.829±0.008,差异有统计学意义(t=4.3,P＜0.01);舌咽平面截面积由(291.7±107.8)mm2增加至(398.1±94.5)mm2,差异有统计学意义(t=3.318,P＜0.05).44例患者中治愈18例(40.9％),显效20例(45.5％),有效4例(9.0％),无效2例(4.5％),4例患者术后半年有轻微吞咽障碍,1例发生术后咽瘘,予以常规换药,加压包扎2周后痊愈.另有1例术后11d出现扁桃体窝出血,压迫止血后出血停止.结论 颈外进路舌根部分切除术是治疗0SAHS患者舌咽平面狭窄的有益尝试与补充.
目的 探討頸外進路舌根部分切除術聯閤腭嚥成形術治療因舌嚥平麵狹窄導緻阻塞性睡眠呼吸暫停低通氣綜閤徵(OSAHS)患者的手術方法及療效.方法 2012年3月至2013年7月對44例舌嚥平麵狹窄的重度OSAHS患者行頸外進路舌根部分切除術聯閤懸雍垂腭嚥成形術,術前及術後行上氣道CT等相關檢查,分析44例患者手術前後的療效及各種參數的變化情況.結果 44例患者手術後半年呼吸暫停低通氣指數(AHI,(-x)±s,下同)由(67.5±21.1)次/h降低至(10.5±6.8)次/h,差異有統計學意義(t=2.1,P＜0.01);最低血氧飽和度由0.694±0.009提高至0.829±0.008,差異有統計學意義(t=4.3,P＜0.01);舌嚥平麵截麵積由(291.7±107.8)mm2增加至(398.1±94.5)mm2,差異有統計學意義(t=3.318,P＜0.05).44例患者中治愈18例(40.9％),顯效20例(45.5％),有效4例(9.0％),無效2例(4.5％),4例患者術後半年有輕微吞嚥障礙,1例髮生術後嚥瘺,予以常規換藥,加壓包扎2週後痊愈.另有1例術後11d齣現扁桃體窩齣血,壓迫止血後齣血停止.結論 頸外進路舌根部分切除術是治療0SAHS患者舌嚥平麵狹窄的有益嘗試與補充.
목적 탐토경외진로설근부분절제술연합악인성형술치료인설인평면협착도치조새성수면호흡잠정저통기종합정(OSAHS)환자적수술방법급료효.방법 2012년3월지2013년7월대44례설인평면협착적중도OSAHS환자행경외진로설근부분절제술연합현옹수악인성형술,술전급술후행상기도CT등상관검사,분석44례환자수술전후적료효급각충삼수적변화정황.결과 44례환자수술후반년호흡잠정저통기지수(AHI,(-x)±s,하동)유(67.5±21.1)차/h강저지(10.5±6.8)차/h,차이유통계학의의(t=2.1,P＜0.01);최저혈양포화도유0.694±0.009제고지0.829±0.008,차이유통계학의의(t=4.3,P＜0.01);설인평면절면적유(291.7±107.8)mm2증가지(398.1±94.5)mm2,차이유통계학의의(t=3.318,P＜0.05).44례환자중치유18례(40.9％),현효20례(45.5％),유효4례(9.0％),무효2례(4.5％),4례환자술후반년유경미탄인장애,1례발생술후인루,여이상규환약,가압포찰2주후전유.령유1례술후11d출현편도체와출혈,압박지혈후출혈정지.결론 경외진로설근부분절제술시치료0SAHS환자설인평면협착적유익상시여보충.
Objective To treat severe obstructive sleep apnea-hypopnea syndrome (OSAHS) with transcervical tongue partial reduction and evaluate treating effect.Methods Forty four patients of severe OSAHS were treated with transcervical tongue partial reduction + uvulopalatopharyngoplasty (UPPP).Apnea hypopnea index (AHI),minimal oxygen percent saturation,body mass index (BMI),area of retroglossal region were measured for diagnosis and evaluation.Results AHI decreased from(67.5 ± 21.1)times/h to (10.5 ± 6.8) times/h (t =2.1,P ＜ 0.01).The lowest oxygen percent saturation increased from 0.694 ± 0.009 to 0.829 ± 0.008 (t =4.3,P ＜ 0.01).The area of retroglossal region increased from (291.7 ± 107.8) mm2 to (398.1 ± 94.5) mm2 (t =3.318,P ＜ 0.05).Four patients complained dysphagia half year after operation.One patient complained about pharyngeal fistula,which disappeared in 2 weeks.One patient appeared hypoglossis bleeding,which stopped after compression.Conclusion Transcervical tongue partial reduction is an effective attempt and supplement for OSAHS with retroglossal region narrow.
