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目的 :术前用纤维鼻咽镜判断阻塞性睡眠呼吸暂停综合征 (OSAS)患者咽腔阻塞部位 ,提高悬雍垂腭咽成形术 (UPPP)疗效。方法 :2 8例OSAS患者术前分别做M櫣ｌｌｅｒ检查和睡眠状态咽腔观察 ,根据阻塞部位的不同 ,将其分为口咽阻塞型、口咽加下咽阻塞型两种类型。通过术前、术后多导睡眠描记图变化比较两型患者的客观疗效。结果 :①M櫣ｌｌｅｒ检查方法 :口咽阻塞型的AHI从 5 2 .7降至 19.7,最低血氧饱和度 (SaO2 )由 63 .1%升至 80 .0 % (均P <0 .0 1) ;口咽加下咽阻塞型的AHI从 5 4.7降至 3 8.6,最低SaO2 由 60 .7%升至 67.0 % (均P >0 .0 5 )。两型手术有效率分别为 68.4%和 2 2 .2 % (P <0 .0 1)。②睡眠咽腔观察法 :口咽阻塞型的AHI从 48.6降至 18.7,最低SaO2 由 65 %升至 80 % (均P <0 .0 1) ;口咽加下咽阻塞型的AHI从 5 9降至 3 4(P <0 .0 1) ,最低SaO2 由 5 9%升至 71% (P <0 .0 5 )。两型手术有效率分别为 73 .3 %和 3 0 .8% (P <0 .0 5 )。结论 :OSAS患者术前咽腔阻塞定位分析有助于改善UPPP手术疗效
OBJECTIVE: To evaluate the effect of uvulopalatopharyngoplasty (UPPP) by using fiber nasopharyngoscopy to determine the obstruction of the pharyngeal cavity in patients with obstructive sleep apnea syndrome (OSAS) before operation. Methods: Twenty-eight OSAS patients underwent preoperative M 櫣 ller examination and pharyngeal observation of sleep state. According to the different occlusion sites, they were divided into two types: obstructive oropharyngeal obstruction and oropharyngeal obstruction. Through the preoperative and postoperative polysomnography changes in two types of patients compared the objective efficacy. Results: ①M 櫣 ller examination method: oropharyngeal obstruction type AHI dropped from 52.7 to 19.7, the minimum oxygen saturation (SaO2) increased from 63.1% to 80.0% (all P <0.01 ). The AHI of oropharyngeal and pharyngeal occlusion decreased from 57.7 to 8.66, and the minimum SaO2 increased from 60.7% to 67.0% (all P> 0.05). The two types of operative efficiency were 68.4% and 22.2% (P <0.01). ② sleep pharyngeal observation: oropharyngeal obstruction AHI dropped from 48.6 to 18.7, the minimum SaO2 increased from 65% to 80% (all P <0.01); oropharyngeal pharyngeal obstruction type AHI from 5 9 To 34 (P <0. 01), the lowest SaO2 increased from 59% to 71% (P <0.05). The two types of operative efficiency were 73.3% and 30.8% (P <0.05). Conclusion: The preoperative diagnosis of pharyngeal obstruction in OSAS patients may help to improve the efficacy of UPPP