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目的:探讨鼻部相关手术对阻塞性睡眠呼吸暂停低通气综合征(OSAHS)治疗的有效性。方法:回顾性分析94例OSAHS合并鼻部相关疾病的患者,均经PSG、鼻内镜、鼻咽纤维镜检查确诊,因种种原因只行鼻部相关手术而未行其他任何治疗。鼻部相关手术包括鼻中隔矫正术,双下鼻甲等离子射频消融术,鼻息肉、慢性鼻窦炎患者行功能性鼻内镜手术。术后2个月、1年复查PSG。结果:94例患者鼻部手术后有效19例,术前AHI11.7±5.2,最低SaO287.6±2.7,平均SaO287.8±5.4,术后2个月AHI5.5±5.0,最低SaO292.5±5.3,平均SaO294.5±3.7,术后1年AHI6.1±4.2,最低SaO291.8±4.2,平均SaO292.8±4.1,有效率20.21%(19/94),均为轻度Ⅰ型患者,占轻度患者的38.00%(19/50),经PSG随访1年无复发。其余75例无效。结论:伴有鼻部相关疾病的OSAHS患者,单纯鼻部手术仅对部分以鼻部阻塞为主的Ⅰ型患者有效。
Objective: To investigate the effectiveness of nasal surgery in obstructive sleep apnea-hypopnea syndrome (OSAHS). Methods: A retrospective analysis of 94 patients with OSAHS complicated with nasal diseases was confirmed by PSG, endoscopic and nasopharyngeal fibroscopy. For various reasons, only nasal surgery was performed without any other treatment. Nasal-related procedures include nasal septum surgery, double inferior turbinate plasma radiofrequency ablation, nasal polyps, and chronic sinusitis in patients undergoing functional endoscopic sinus surgery. Postoperative 2 months, 1 year review PSG. Results: Ninety-four patients were effective after nasal surgery, preoperative AHI11.7 ± 5.2, the lowest SaO287.6 ± 2.7, the average SaO287.8 ± 5.4, AHI5.5 ± 5.0 after 2 months, the lowest SaO292.5 ± 5.3, mean SaO294.5 ± 3.7, AHI6.1 ± 4.2 at 1 year after surgery, the lowest SaO291.8 ± 4.2, the average SaO292.8 ± 4.1, and the effective rate of 20.21% (19/94) Patients, accounting for 38.00% (19/50) of mild patients, had no recurrence after one year follow-up of PSG. The remaining 75 cases are invalid. CONCLUSIONS: In patients with OSAHS associated with nasal diseases, simple nasal surgery is only effective for type I patients who are predominantly obstructed nasal obstruction.