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射频辅助悬雍垂腭咽成形术治疗打鼾及单次治疗方案的效果:一项前瞻性、纵向、非随机研究。

The treatment of snoring by radiofrequency-assisted uvulopalatoplasty and results after one-session protocol: a prospective, longitudinal, non-randomized study.

作者信息

Chiesa Estomba Carlos Miguel, Rivera Schmitz Teresa, Ossa Echeverri Carla Cristina, Betances Reinoso Frank Alberto, Fariña Conde José, Alonso Parraga Dionisio

机构信息

Department of Otorhinolaryngology-Head and Neck Surgery, University Hospital of Vigo, rua Pizarro, #11, 4to D, 36204, Vigo, Pontevedra, Spain,

出版信息

Eur Arch Otorhinolaryngol. 2015 Oct;272(10):3059-63. doi: 10.1007/s00405-015-3617-6. Epub 2015 Apr 3.

Abstract

Snoring is usually caused by the vibration of walls of the soft palate at the pharyngeal level. Its worldwide prevalence is estimated to range between 2 and 85% depending on age, gender or population group. The aim of this study is to determine the degree of improvement that can be subjectively evident in patients treated by snoring with radiofrequency-assisted uvulopalatoplasty based on a one-session protocol. This is a prospective, longitudinal, non-randomized study. Patients of both sexes, aged 18 years, who attended to the ENT consultation in a tertiary hospital with snoring during the period of July 2012-July 2013 were included. Age, body mass index, Epworth sleepiness scale were calculated. The volume of snoring of each subject was assessed using a visual analog scale. A total of 27 patients were included in the study; the average age of the sample was 49 years (±8.7; min 36/max 74); of these 22 (81.5%) were male and 5 (18.5%) females. The average BMI was 27.07 ± 2.5 (min 23.15/max 29.39) before the test and after 1 year was 26.75 ± 2.32 (min 23.11/max 29.56) with no statistically significant differences in BMI before and after surgery (p = 0.407). Preoperative snoring intensity was 8.10 ± 0.93 according to VAS. We found a statistically significant difference in the post-operative intensity at 3 months of 3.93 ± 0.88 (p ≤ 0.05) at 6 months of 4.41 ± 1.08 (p ≤ 0.05), and after 1 year 4.90 ± 0.77 (p ≤ 0.05). The average rate of ESS was significantly higher preoperatively than post-operative, being 8.76 ± 3.1 preoperative and 6.93 ± 1.68 post-operative (p ≤ 0.05). We conclude that the use of radiofrequency in simple snorers with an apnea/hypopnea index <15 events per hour and a BMI < 30 kg/m(2) in whom clinically proven that the source of snoring is the soft palate, can be treated by one-session protocol, being possible to obtain an improvement of snoring up to 70% of cases by a short follow-up period.

摘要

打鼾通常是由咽水平软腭壁的振动引起的。根据年龄、性别或人群组的不同,其全球患病率估计在2%至85%之间。本研究的目的是确定基于单疗程方案,采用射频辅助悬雍垂腭咽成形术治疗打鼾患者后,主观上可明显看出的改善程度。这是一项前瞻性、纵向、非随机研究。纳入了2012年7月至2013年7月期间在一家三级医院因打鼾就诊于耳鼻喉科门诊的18岁及以上的男女患者。计算了年龄、体重指数、爱泼华嗜睡量表得分。使用视觉模拟量表评估每个受试者的打鼾音量。共有27名患者纳入研究;样本的平均年龄为49岁(±8.7;最小36/最大74);其中22名(81.5%)为男性,5名(18.5%)为女性。测试前平均体重指数为27.07±2.5(最小23.15/最大29.39),1年后为26.75±2.32(最小23.11/最大29.56),手术前后体重指数无统计学显著差异(p = 0.407)。根据视觉模拟量表,术前打鼾强度为8.10±0.93。我们发现术后3个月强度为3.93±0.88(p≤0.05)、6个月时为4.41±1.08(p≤0.05)以及1年后为4.90±0.77(p≤0.05),均有统计学显著差异。术前爱泼华嗜睡量表平均得分显著高于术后,术前为8.76±3.1,术后为6.93±1.68(p≤0.05)。我们得出结论,对于呼吸暂停低通气指数每小时<15次事件且体重指数<30kg/m²、经临床证实打鼾源为软腭的单纯打鼾者,采用单疗程方案使用射频进行治疗,在短期随访期内有可能使70%的病例的打鼾情况得到改善。

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