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经扁桃体切除术的射频辅助悬雍垂腭咽成形术治疗阻塞性睡眠呼吸暂停综合征。

Treatment of obstructive sleep apnea syndrome using radiofrequency-assisted uvulopalatoplasty with tonsillectomy.

机构信息

Department of Otolaryngology-Head and Neck Surgery, School of Medicine, Konkuk University Chungju Hospital, 620-5 Kyohyun-dong, Chungju-si, Chungbuk 380-704, South Korea.

出版信息

Eur Arch Otorhinolaryngol. 2013 Feb;270(2):585-93. doi: 10.1007/s00405-012-2082-8. Epub 2012 Jun 22.

Abstract

Radiofrequency surgery was introduced to minimize thermal damage to the tissue. A radiofrequency electrode can be used to make cuts in the free edge of the soft palate like those done in laser-assisted uvulopalatoplasty [radiofrequency-assisted uvulopalatoplasty (RAUP)]. Tonsillectomy can enlarge the lateral diameter of the pharynx. The aim of our study was to evaluate the efficacy of RAUP with tonsillectomy in treatment of obstructive sleep apnea syndrome (OSAS). Ninety-two patients with obstructive sleep apnea were included in this study. Patients were categorized according to disease severity and Friedman's staging system. Patients were assessed with the preoperative visual analog scale (VAS) for snoring, Epworth Sleepiness Scale (ESS) and apnea-hypopnea index (AHI) at baseline and repeated at 6 months postoperatively. The intensity of postoperative pain, speech deficits and dysphagia were also recorded. There was a significant improvement in the VAS score for snoring, ESS and AHI before and after surgery. Overall, the results of the present study indicated a surgery success rate (a 50 % decrease in AHI and AHI <20) of 66 % (61 of 92 patients). Postoperative pain, speech deficits and dysphagia were reduced at 2 weeks after surgery. The results of this study suggest that RAUP with tonsillectomy is an effective treatment for patients with OSAS.

摘要

射频手术被引入以最小化对组织的热损伤。射频电极可用于切割软腭的游离缘,就像在激光辅助悬雍垂腭咽成形术中一样[射频辅助悬雍垂腭咽成形术(RAUP)]。扁桃体切除术可以扩大咽腔的横向直径。我们的研究目的是评估 RAUP 联合扁桃体切除术治疗阻塞性睡眠呼吸暂停综合征(OSAS)的疗效。本研究纳入了 92 例阻塞性睡眠呼吸暂停患者。根据疾病严重程度和 Friedman 分期系统对患者进行分类。患者在术前使用视觉模拟量表(VAS)评估打鼾、嗜睡量表(ESS)和呼吸暂停低通气指数(AHI),并在术后 6 个月重复评估。还记录了术后疼痛强度、言语障碍和吞咽困难。打鼾、ESS 和 AHI 的 VAS 评分在术前和术后均有显著改善。总体而言,本研究结果表明手术成功率(AHI 降低 50%且 AHI<20)为 66%(92 例患者中的 61 例)。术后 2 周,疼痛、言语障碍和吞咽困难减轻。这项研究的结果表明,RAUP 联合扁桃体切除术是治疗 OSAS 患者的有效方法。

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