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激光辅助悬雍垂腭成形术治疗打鼾:它是否符合预期?

Laser-assisted uvulopalatoplasty for snoring: does it meet the expectations?

作者信息

Larrosa F, Hernandez L, Morello A, Ballester E, Quinto L, Montserrat J M

机构信息

Otorhinolaryngology Service, Institut d'Investigacions Biomediques August Pi Sunyer, University of Barcelona, Barcelona, Spain.

出版信息

Eur Respir J. 2004 Jul;24(1):66-70. doi: 10.1183/09031936.04.00082903.

Abstract

The high prevalence of habitual snoring (35% of the general population) and the increasing demand for an effective treatment have led, in the last decade, to the generalisation of laser-assisted uvulopalatoplasty (LAUP). However, acceptable studies on its effectiveness are lacking. The present randomised, placebo-controlled study included 25 nonapnoeic and mild obstructive sleep apnoea snorers to evaluate LAUP effectiveness for snoring. Group I received a one-stage LAUP treatment and group II a placebo (simulated snore surgery followed by an oral placebo). Before each treatment and 3 months after, the variables and procedures assessed were: body weight; sleepiness (Epworth sleepiness scale); quality of life (SF-36); subjective snoring intensity (0-10 analogue scale); objective snoring intensity (average decibel intensity); snoring index (number of snores per hour); and apnoea/hypopnea index. No differences were observed in body weight, sleepiness, quality of life, subjective and objective intensity, and frequency of snoring, and apnoea/hypopnea index between the groups before and 3 months after treatment. In conclusion, this study provides evidence of the lack of effectiveness of one-stage laser-assisted uvulopalatoplasty for snoring in nonapnoeic and mild obstructive sleep apnoea patients, with the result that it does not meet the expectations generated by the procedure.

摘要

习惯性打鼾的高患病率(占普通人群的35%)以及对有效治疗的需求不断增加,在过去十年中导致了激光辅助悬雍垂腭咽成形术(LAUP)的广泛应用。然而,缺乏关于其有效性的可接受研究。本随机、安慰剂对照研究纳入了25名无呼吸暂停和轻度阻塞性睡眠呼吸暂停的打鼾者,以评估LAUP治疗打鼾的有效性。第一组接受一期LAUP治疗,第二组接受安慰剂治疗(模拟打鼾手术,随后口服安慰剂)。在每次治疗前和治疗后3个月,评估的变量和程序包括:体重;嗜睡程度(爱泼华嗜睡量表);生活质量(SF-36);主观打鼾强度(0-10模拟量表);客观打鼾强度(平均分贝强度);打鼾指数(每小时打鼾次数);以及呼吸暂停/低通气指数。治疗前和治疗后3个月,两组在体重、嗜睡程度、生活质量、主观和客观强度、打鼾频率以及呼吸暂停/低通气指数方面均未观察到差异。总之,本研究提供了证据,表明一期激光辅助悬雍垂腭咽成形术对无呼吸暂停和轻度阻塞性睡眠呼吸暂停患者的打鼾无效,因此该手术未达到其产生的预期效果。

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