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168例打鼾患者激光辅助悬雍垂腭成形术的长期疗效

Long-term outcomes of laser-assisted uvulopalatoplasty in 168 patients with snoring.

作者信息

Iyngkaran T, Kanagalingam J, Rajeswaran R, Georgalas C, Kotecha B

机构信息

Royal National Throat, Nose and Ear Hospital, London, UK.

出版信息

J Laryngol Otol. 2006 Nov;120(11):932-8. doi: 10.1017/S002221510600209X. Epub 2006 Jul 3.

DOI:10.1017/S002221510600209X
PMID:17040580
Abstract

Laser-assisted uvulopalatoplasty (LAUP) is an established treatment for snoring. Our institution has been using a modification of the Kamami technique since 1995. Between January 1995 and December 2001, 469 patients underwent LAUP for snoring. A telephone survey of these patients and their partners was conducted retrospectively. One hundred and sixty-eight patients and their partners were interviewed and the findings analysed.Of the 168 patients, 122 had LAUP alone, 42 had LAUP and tonsillectomy and four had LAUP and septoplasty. The median follow-up time was 59 months (range 19 to 98 months).Seventy-four per cent reported improvement at six weeks, 69 per cent reported improvement at nine months and 55 per cent reported improvement at the time of interview. To assess the degree of improvement, patients and their partners were asked to grade any improvement in percentage terms. The mean subjective improvement scores were 57 per cent at six weeks (95 per cent confidence interval (CI) 50-64 per cent), 45 per cent at nine months (95 per cent CI 38-59 per cent) and 30 per cent at the time of interview (95 per cent CI 23-35 per cent). Patients who reported weight gain since surgery did not have a poorer outcome than those who reported no weight change or weight loss. Neither did weight loss predict a better outcome. The procedure was generally well tolerated, with only 30 patients (18 per cent) reporting complications (mainly minor). The benefits of LAUP wane with time and the results are best in the first 12 months following surgery. Our study suggests that 55 per cent of patients selected after sleep studies and sleep nasendoscopy will enjoy long-term benefit.

摘要

激光辅助悬雍垂腭咽成形术(LAUP)是一种已确立的治疗打鼾的方法。自1995年以来,我们机构一直在使用改良的镰见技术。1995年1月至2001年12月期间,469例患者因打鼾接受了LAUP治疗。对这些患者及其伴侣进行了回顾性电话调查。对168例患者及其伴侣进行了访谈并分析了结果。在这168例患者中,122例仅接受了LAUP,42例接受了LAUP和扁桃体切除术,4例接受了LAUP和鼻中隔成形术。中位随访时间为59个月(范围19至98个月)。74%的患者在6周时报告有改善,69%的患者在9个月时报告有改善,55%的患者在访谈时报告有改善。为了评估改善程度,要求患者及其伴侣用百分比对任何改善进行评分。主观改善的平均得分在6周时为57%(95%置信区间(CI)50 - 64%),在9个月时为45%(95%CI 38 - 59%),在访谈时为30%(95%CI 23 - 35%)。报告自手术以来体重增加的患者与报告体重无变化或体重减轻的患者相比,预后并不更差。体重减轻也不能预测更好的预后。该手术一般耐受性良好,只有30例患者(18%)报告有并发症(主要是轻微并发症)。LAUP的益处会随着时间减弱,术后前12个月效果最佳。我们的研究表明,经睡眠研究和睡眠鼻内镜检查后选择的患者中有55%将获得长期益处。

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