扩张括约肌咽成形术：一种治疗阻塞性睡眠呼吸暂停的新技术。
Expansion sphincter pharyngoplasty: a new technique for the treatment of obstructive sleep apnea.
作者信息
Pang Kenny P, Woodson B Tucker
机构信息
Deaprtment of Otolaryngology, Pacific Sleep Centre, 20-01 Paragon, Paragon Medical Centre, Singapore, Republic of Singapore.
出版信息
Otolaryngol Head Neck Surg. 2007 Jul;137(1):110-4. doi: 10.1016/j.otohns.2007.03.014.
OBJECTIVE
In this study, we assessed the efficacy of a new method (expansion sphincter pharyngoplasty [ESP]) to treat obstructive sleep apnea.
STUDY DESIGN
We conducted a prospective, randomized controlled trial.
METHODS
Forty-five adults with small tonsils, body mass index less than 30 kg/m2, of Friedman stage II or III, of type I Fujita, and with lateral pharyngeal wall collapse were selected for the study.
RESULTS
The mean body mass index was 28.7 kg/m2. The apnea-hypopnea index improved from 44.2 +/- 10.2 to 12.0 +/- 6.6 (P < 0.005) following ESP and from 38.1 +/- 6.46 to 19.6 +/- 7.9 in the uvulopalatopharyngoplasty group (P < 0.005). Lowest oxygen saturation improved from 78.4 +/- 8.52% to 85.2 +/- 5.1% in the ESP group (P = 0.003) and from 75.1 +/- 5.9% to 86.6 +/- 2.2% in the uvulopalatopharyngoplasty group (P < 0.005). Selecting a threshold of a 50% reduction in apnea-hypopnea index and apnea-hypopnea index less than 20, success was 82.6% in ESP compared with 68.1% in uvulopalatopharyngoplasty (P < 0.05).
CONCLUSION/SIGNIFICANCE: The ESP may offer benefits in a selected group of OSA patients.
目的
在本研究中，我们评估了一种新方法（扩张括约肌咽成形术[ESP]）治疗阻塞性睡眠呼吸暂停的疗效。
研究设计
我们进行了一项前瞻性随机对照试验。
方法
选取45例扁桃体小、体重指数小于30kg/m²、Friedman II期或III期、I型藤田型且存在咽侧壁塌陷的成年人进行研究。
结果
平均体重指数为28.7kg/m²。ESP术后呼吸暂停低通气指数从44.2±10.2改善至12.0±6.6（P<0.005），悬雍垂腭咽成形术组从38.1±6.46改善至19.6±7.9（P<0.005）。ESP组最低氧饱和度从78.4±8.52%提高至85.2±5.1%（P=0.003），悬雍垂腭咽成形术组从75.1±5.9%提高至86.6±2.2%（P<0.005）。以呼吸暂停低通气指数降低50%且呼吸暂停低通气指数小于20为阈值，ESP组成功率为82.6%，悬雍垂腭咽成形术组为68.1%（P<0.05）。
结论/意义：ESP可能对特定组别的阻塞性睡眠呼吸暂停患者有益。
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