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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/m2,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%。
Objective To study the combined nasal and oropharyngeal obstructive sleep apnea-hypopnea syndrome, while completing the modified E-pharyngeal surgery (H-UPPP) and endoscopic sinus surgery to explore a multi-plane surgery to OSAHS patients treatment method. Methods Thirty-two patients with OSAHS, aged 23-45 years (average 34.3 years), including 30 males and 2 females, had a body mass index of 21.8-35.7 kg / m2. The apnea and hypopnea index AHI) 15.4 ~ 39.7 times / h, an average of 25.7 times / h, the lowest oxygen saturation 67 ~ 87, an average of 77 preoperative nasopharyngoscopy obstruction plane are located in the nasal cavity and oropharynx, tongue and epiglottis without stenosis. Preoperative CT tomography nasal cavity and oropharynx clear diagnosis of stenosis plane to determine the personalized warlock, general anesthesia nasal intubation postoperative endoscopic nasal endoscopic silicone tube compression support, and then H-UPPP surgery. Results One week, two months and six months postoperatively, PTT sleep monitoring was performed. The total effective rate of 32 patients was 100%.