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[阻塞性睡眠呼吸暂停综合征的外科治疗:乌尔姆治疗方案的结果]

[Surgical therapy of obstructive sleep apnea syndromes: results of the Ulm treatment program].

作者信息

Schäfer J, Pirsig W

机构信息

Hals-Nasen-Ohren-Klinik, Universität Ulm.

出版信息

Pneumologie. 1991 May;45 Suppl 1:283-6.

PMID:1866409
Abstract

The article reports on the results obtained by uvulopalatopharyngoplastic surgery (= UPPPS) in 31 patients suffering from obstructive sleep apnoea syndrome (= OSAS) and in 9 patients with habitual or obstructive snoring. All patients were subjected to thorough preoperative examination including rhinometry, nasopharyngeal video-endoscopy, radiocephalometry and polysomnography. In 8 out of 9 (89%) of the habitually snoring patients and in 17 of 31 (55%) of OSAS patients, surgery was successful. In these patients, a postoperative respiratory disturbance index (RDI) of less than 10 was recorded, whereas in 4 patients (13%) the postoperative RDI was between 10 and 15. Ten patients did not respond satisfactorily to UPPPS (32%). RDI was postoperatively still above 15. Analysis of patient data shows that almost all habitually snoring patients and the OSAS patients with slight overweight and low to medium apnoea index were successfully treated with UPPPS. In accordance with these results a treatment concept has been drawn up for OSAS patients that takes stock of all the possibilities and limitations of available conservative and surgical treatment methods.

摘要

本文报道了31例阻塞性睡眠呼吸暂停综合征(OSAS)患者和9例习惯性打鼾或阻塞性打鼾患者接受悬雍垂腭咽成形术(UPPPS)的结果。所有患者均接受了全面的术前检查,包括鼻阻力测量、鼻咽视频内镜检查、头影测量和多导睡眠图检查。9例习惯性打鼾患者中有8例(89%)手术成功,31例OSAS患者中有17例(55%)手术成功。这些患者术后呼吸紊乱指数(RDI)小于10,而4例患者(13%)术后RDI在10至15之间。10例患者对UPPPS反应不佳(32%),术后RDI仍高于15。对患者数据的分析表明,几乎所有习惯性打鼾患者以及轻度超重、低至中度呼吸暂停指数的OSAS患者都通过UPPPS得到了成功治疗。根据这些结果,为OSAS患者制定了一个治疗方案,该方案考虑了现有保守和手术治疗方法的所有可能性和局限性。

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