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悬雍垂腭咽成形术仍是治疗阻塞性睡眠呼吸暂停的选择吗?

Is uvulopalatopharyngoplasty still an option for the treatment of obstructive sleep apnea?

机构信息

Division of Otorhinolaryngology, School of Medicine of Ribeirão Preto, University of São Paulo, Av. Bandeirantes, 3900-12o andar, Ribeirão Preto 14049-900, SP, Brazil.

出版信息

Eur Arch Otorhinolaryngol. 2013 Feb;270(2):549-54. doi: 10.1007/s00405-012-2042-3. Epub 2012 May 13.

Abstract

Uvulopalatopharyngoplasty (UPPP) has been widely described as a surgical option for the treatment of obstructive sleep apnea syndrome. Several studies have demonstrated variable success rates, and different criteria have been used to define success of surgery. The aim of the present study was to assess the efficiency of UPPP by polysomnography and to correlate it to the clinical findings. Also, we correlated to the various studies dealing with this topic, considering the different criteria adopted in each of this. Sixty-four patients were included in the study. The efficiency of surgery for UPPP was analyzed to the variables such as body mass index, age, preoperative polysomnography results and follow-up period. Based on the criteria for postoperative cure, the success rate was 44 %. Younger patients presented a better success rate than older ones. No other correlation was found between clinical findings and UPPP success. UPPP can be curative in some patients, but combination with other treatment modalities must be considered. This should be mentioned to the patients, since in many cases the sites of airway collapse may be multiple and no clinical aspect (except for age) is indicative of good prognosis.

摘要

悬雍垂腭咽成形术(UPPP)已被广泛描述为治疗阻塞性睡眠呼吸暂停综合征的一种手术选择。多项研究已经证明了不同的成功率,并且已经使用了不同的标准来定义手术的成功。本研究的目的是通过多导睡眠图评估 UPPP 的疗效,并将其与临床发现相关联。此外,我们还与涉及该主题的各种研究相关联,考虑到了每个研究中采用的不同标准。本研究共纳入 64 例患者。UPPP 手术的疗效分析变量包括体重指数、年龄、术前多导睡眠图结果和随访时间。根据术后治愈标准,成功率为 44%。年轻患者的成功率高于老年患者。临床发现与 UPPP 成功率之间没有其他相关性。UPPP 可以治愈一些患者,但必须考虑与其他治疗方法相结合。应该向患者提及这一点,因为在许多情况下,气道塌陷的部位可能是多个,并且没有任何临床方面(除了年龄)可以预示良好的预后。

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