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SLEEP 研究:悬雍垂腭咽成形术(UPPP)的主观疗效及生活质量影响研究:孤立性 UPPP 的疗效。

Studying Life Effects & Effectiveness of Palatopharyngoplasty (SLEEP) study: subjective outcomes of isolated uvulopalatopharyngoplasty.

机构信息

Department of Otolaryngology/Head & Neck Surgery, University of Washington, Seattle, Washington 98108, USA.

出版信息

Otolaryngol Head Neck Surg. 2011 Apr;144(4):623-31. doi: 10.1177/0194599810394982. Epub 2011 Feb 10.

Abstract

OBJECTIVE

To test the hypothesis that uvulopalatopharyngoplasty (UPPP) improves sleep apnea-related quality of life (measured on the Functional Outcomes of Sleep Questionnaire [FOSQ]) at 3-month follow-up. Secondary objectives were to test (1) the stability of the outcomes at 6 months, (2) the effect on global sleep apnea quality-of-life change, and (3) the effect on sleep apnea symptoms.

STUDY DESIGN

Multicenter, prospective, longitudinal case series.

SETTING

Diverse university- and community-based otolaryngology practices.

SUBJECTS AND METHODS

The cohort included 68 patients from 17 practices, with a mean ± standard deviation age of 44 ± 12 years and mean apnea-hypopnea index of 35 ± 32 events/hour. All patients underwent UPPP, defined as an open procedure modifying the shape and size of the palate, pharynx, and uvula, with or without tonsillectomy. Baseline data were collected on site before surgery, and outcome data were collected by mail 3 and 6 months after surgery, with follow-up rates of 51% and 50%, respectively.

RESULTS

FOSQ scores improved from 14.3 ± 3.4 (scale 5-20, normal ≥17.9) at baseline to 17.2 ± 2.7 at 3 months (mean improvement 2.9; 95% confidence interval, 1.8-4.0; P < .001) and 17.5 ± 2.5 at 6 months (mean improvement 3.1; 95% confidence interval, 2.0-4.2; P < .001). All quality-of-life and symptom measures improved significantly at 3 and 6 months (all P < .05).

CONCLUSION

This prospective, multicenter, university- and community-based study provides evidence that UPPP significantly improves disease-specific quality of life and sleep apnea symptoms in patients with sleep apnea. Validity may be limited by significant loss to follow-up and absence of an unoperated control group.

摘要

目的

检验悬雍垂腭咽成形术(UPPP)是否能改善睡眠呼吸暂停相关的生活质量(采用睡眠问卷功能结局量表[FOSQ]进行测量),随访时间为术后 3 个月。次要目标是检验(1)6 个月时结果的稳定性,(2)对整体睡眠呼吸暂停生活质量变化的影响,以及(3)对睡眠呼吸暂停症状的影响。

研究设计

多中心、前瞻性、纵向病例系列研究。

地点

分布在多个大学和社区的耳鼻喉科诊所。

对象和方法

该队列纳入了来自 17 个诊所的 68 例患者,平均年龄±标准差为 44±12 岁,平均呼吸暂停低通气指数为 35±32 次/小时。所有患者均接受了 UPPP,定义为一种开放手术,可改变腭、咽和悬雍垂的形状和大小,可能还包括扁桃体切除术。术前在现场收集基线数据,术后 3 个月和 6 个月通过邮件收集结局数据,随访率分别为 51%和 50%。

结果

FOSQ 评分从术前的 14.3±3.4(评分范围 5-20,正常评分≥17.9)改善至术后 3 个月的 17.2±2.7(平均改善 2.9;95%置信区间,1.8-4.0;P<.001)和术后 6 个月的 17.5±2.5(平均改善 3.1;95%置信区间,2.0-4.2;P<.001)。所有生活质量和症状测量指标在术后 3 个月和 6 个月时均显著改善(均 P<.05)。

结论

这项前瞻性、多中心、大学和社区基础研究提供了证据,表明 UPPP 可显著改善睡眠呼吸暂停患者的疾病特异性生活质量和睡眠呼吸暂停症状。由于随访损失显著且缺乏未手术对照组,有效性可能受限。

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