Hui Peilin, Xie Yuping, Wei Xiaoquan, Zhao Lijun, Ma Wei, Wang Jinfeng, Ning Jing, Xu Chao, Yang Qian, Kang Hong
Lin Chuang Er Bi Yan Hou Tou Jing Wai Ke Za Zhi. 2015 Mar;29(6):504-8.
To investigate the therapeutic effects of oral modified device combined with nasopharyngeal enlargement surgery and evaluate the oral modified device' s adjuvant therapy meaning in severe OSAHS patients after surgery treatment.
46 cases with severe OSAHS were diagnosed by PSG according to AHI and the lowest arterial oxygen saturation (LSaO2). We performed the nasal or pharyngeal cavity expansion surgery for them according to the pathological change part correspondingly. Then all subjects were divided into combined group (n=26) and surgery alone group (n=20) according to their personal willingness. We monitored the PSG for all subjects aftter 2 weeks and 3 months respectively, then we calculate the diversity between the two group or intragroup change on the basis of the AHI, LAT, LSaO2, mean arterial oxygen saturation (MSaO2) and sleep structures recorded by PSG. At the same time, we collected the subjective sensations by questionnaire.
The AHI and LAT in combined group were significantly lower and LSaO2 was significantly higher than these in surgery alone group(P<0. 05), and it's no difference in MSO2 between the two groups (P>0. 05). The N 1% was more shorter and the N2% and N3% were more longer after nasal or pharyngeal operation compared with pre-operative states in both groups(P<. 05), but we didn't find difference in REM%(P>. 05). The data of PSG also showed that the shallow sleep proportion was more shorter and the slow wave sleep proportion was more longer in combined group compared with surgery alone group. The subjective sensations results also showed significantly alleviated in combined group, such as mental state, daytime sleepiness and physical strength. The efficiency ratio of treatment was 85. 0% and 92. 3% in surgery alone group and combined group respectively.
Nasal and pharyngeal cavity enlargement surgery combined with oral modified device is a more effective treatment in patients with severe OSAHS, and it is meaningful for the long-term curative effect of surgery to prevent relapse and improve.
探讨口腔改良器联合鼻咽部扩大手术的治疗效果，评估口腔改良器在重度阻塞性睡眠呼吸暂停低通气综合征（OSAHS）患者术后治疗中的辅助治疗意义。
46例重度OSAHS患者通过多导睡眠监测（PSG）根据呼吸暂停低通气指数（AHI）和最低动脉血氧饱和度（LSaO2）进行诊断。根据病变部位相应地对他们进行鼻腔或咽腔扩大手术。然后根据患者个人意愿将所有受试者分为联合组（n = 26）和单纯手术组（n = 20）。分别在2周和3个月后对所有受试者进行PSG监测，然后根据PSG记录的AHI、最长呼吸暂停时间（LAT）、LSaO2、平均动脉血氧饱和度（MSaO2）和睡眠结构计算两组间或组内变化的差异。同时，通过问卷调查收集主观感受。
联合组的AHI和LAT显著低于单纯手术组，LSaO2显著高于单纯手术组（P < 0.05），两组间MSaO2无差异（P > 0.05）。两组鼻腔或咽腔手术后N1%均较术前缩短，N2%和N3%均较术前延长（P < 0.05），但快速眼动睡眠期（REM%）无差异（P > 0.05）。PSG数据还显示，联合组较单纯手术组浅睡眠比例缩短，慢波睡眠比例延长。主观感受结果也显示联合组有明显改善，如精神状态、日间嗜睡和体力。单纯手术组和联合组的治疗有效率分别为85.0%和92.3%。
鼻腔和咽腔扩大手术联合口腔改良器对重度OSAHS患者是一种更有效的治疗方法，对预防手术复发和改善远期疗效具有重要意义。
