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鼻咽管:一种简单有效的工具,可指示是否需要行悬雍垂腭咽成形术。

The nasopharyngeal tube: a simple and effective tool to indicate the need for uvulopalatopharyngoplasty.

机构信息

Department of Otolaryngology-Head and Neck Surgery, General Hospital of Shenyang Military Area Command, Shenyang, China.

出版信息

Laryngoscope. 2014 Apr;124(4):1023-8. doi: 10.1002/lary.24351. Epub 2013 Oct 2.

Abstract

OBJECTIVES/HYPOTHESIS: To compare polysomnography (PSG) data after nasopharyngeal tube (NPT) insertion and uvulopalatopharyngoplasty (UPPP), and explore the possibility of predicting UPPP outcomes with NPT-PSG.

STUDY DESIGN

Prospective nonrandomized study.

METHODS

PSG was performed after NPT insertion in 73 inpatients with obstructive sleep apnea-hypopnea syndrome (OSAHS). All patients accepted UPPP surgery. PSG was repeated after 12 months of UPPP to assess curative effects. Data were then compared to correlate NPT-PSG with the efficacy of UPPP.

RESULTS

NPT insertion decreased the overall apnea-hypopnea index (AHI) and increased the lowest oxygen saturation (LaSO2 ). NPT-PSG results correlated well with surgical outcomes 12 months post-UPPP. The correlation coefficient for AHI and LaSO2 were 0.571 (P < .001) and 0.268 (P = .033), respectively. Next, enrolled patients were divided into two groups based on NPT-PSG results: group A, AHI <15 times/hr, 50 cases; group B, AHI ≥15 times/hr, 23 cases. The UPPP surgery success rates of the two groups were 86.0% and 39.1%, respectively.

CONCLUSIONS

NPT-PSG data are closely correlated with UPPP efficacy and may assist in the selection of appropriate OSAHS patients for UPPP. An AHI ≥15 times/hr after NPT insertion indicates glossopharyngeal obstruction and suggests the need for appropriate intervention.

LEVEL OF EVIDENCE

摘要

目的/假设:比较经鼻咽管(NPT)插入和悬雍垂腭咽成形术(UPPP)后的多导睡眠图(PSG)数据,并探讨使用 NPT-PSG 预测 UPPP 结果的可能性。

研究设计

前瞻性非随机研究。

方法

73 例阻塞性睡眠呼吸暂停低通气综合征(OSAHS)住院患者在接受 NPT 插入后进行 PSG。所有患者均接受 UPPP 手术。UPPP 术后 12 个月重复 PSG 以评估疗效。然后将数据进行比较,以将 NPT-PSG 与 UPPP 的疗效相关联。

结果

NPT 插入降低了总体呼吸暂停低通气指数(AHI),并增加了最低氧饱和度(LaSO2)。NPT-PSG 结果与 UPPP 术后 12 个月的手术结果密切相关。AHI 和 LaSO2 的相关系数分别为 0.571(P < 0.001)和 0.268(P = 0.033)。接下来,根据 NPT-PSG 结果将纳入的患者分为两组:组 A,AHI <15 次/小时,50 例;组 B,AHI ≥15 次/小时,23 例。两组 UPPP 手术成功率分别为 86.0%和 39.1%。

结论

NPT-PSG 数据与 UPPP 疗效密切相关,可协助选择合适的 OSAHS 患者进行 UPPP。NPT 插入后 AHI ≥15 次/小时表明舌咽神经阻塞,并提示需要进行适当的干预。

证据水平

4 级。

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