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激光辅助悬雍垂腭咽成形术治疗阻塞性睡眠呼吸暂停的短期目标和长期主观效果

Short-term objective and long-term subjective results of laser-assisted uvulopalatoplasty for obstructive sleep apnea.

作者信息

Mickelson S A, Ahuja A

机构信息

Atlanta Ear Nose & Throat Associates, GA 30342, USA.

出版信息

Laryngoscope. 1999 Mar;109(3):362-7. doi: 10.1097/00005537-199903000-00004.

Abstract

OBJECTIVES

To determine the short-term and long-term effects of laser-assisted uvulopalatoplasty (LAUP) on symptoms and polysomnographic measures in patients with obstructive sleep apnea syndrome (OSAS).

STUDY DESIGN

Prospective assessment of outcomes after LAUP in patients with OSAS.

METHODS

Fifty-nine patients with OSAS underwent LAUP, and 36 completed postoperative sleep studies. Questionnaires ranking snoring and apneic symptoms were completed by the patient and bed partner before LAUP, 6 to 12 weeks after LAUP, and in the long term (> 2 years).

RESULTS

The apnea index decreased from 14.4 to 5.8 (P = .0012), respiratory disturbance index (RDI) decreased from 28.1 to 7.9 (P = .0046), and the mean lowest oxyhemoglobin saturation increased from 80.6% to 84.0% (P = .055). The RDI was reduced to 10 or less in 44.4% of patients. Subjective questionnaires showed statistically significant improvements in snoring, morning fatigue, morning headaches, daytime somnolence, and daytime psychometric measures. The symptomatic improvement persisted in the long term.

CONCLUSIONS

LAUP is an effective method for the management of OSAS. We have demonstrated short-term improvement in polysomnographic measures and short-term and long-term improvement in subjective measures.

摘要

目的

确定激光辅助悬雍垂腭咽成形术(LAUP)对阻塞性睡眠呼吸暂停综合征(OSAS)患者症状及多导睡眠图指标的短期和长期影响。

研究设计

对OSAS患者接受LAUP后的结局进行前瞻性评估。

方法

59例OSAS患者接受了LAUP,36例完成了术后睡眠研究。患者及其同床伴侣在LAUP前、LAUP后6至12周以及长期(>2年)完成了对打鼾和呼吸暂停症状进行评分的问卷。

结果

呼吸暂停指数从14.4降至5.8(P = .0012),呼吸紊乱指数(RDI)从28.1降至7.9(P = .0046),平均最低氧合血红蛋白饱和度从80.6%升至84.0%(P = .055)。44.4%的患者RDI降至10或更低。主观问卷显示,打鼾、晨起疲劳、晨起头痛、日间嗜睡及日间心理测量指标有统计学意义的改善。症状改善长期持续。

结论

LAUP是治疗OSAS的有效方法。我们已证明多导睡眠图指标有短期改善,主观指标有短期和长期改善。

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