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针对特定阻塞性睡眠呼吸暂停病例的单悬吊缝合与双悬吊缝合

Single versus double suspension sutures for selected cases of obstructive sleep apnea.

作者信息

El-Anwar Mohammad Waheed, Askar Sherif, El-Sinbawy Amr Hassan, Salem Ahmed Mohamed Hassan

机构信息

Otorhinolaryngology Head and Neck Surgery Department, Faculty of Medicine, Zagazig University, Egypt.

Otorhinolaryngology Head and Neck Surgery Department, Faculty of Medicine, Zagazig University, Egypt.

出版信息

Auris Nasus Larynx. 2019 Oct;46(5):754-757. doi: 10.1016/j.anl.2018.12.014. Epub 2019 Jan 6.

Abstract

OBJECTIVE

To compare the results of expansion pharyngoplasty using bilateral single palatal suspension sutures (SSS) versus double suspension sutures (DSS) for the treatment of selected cases of obstructive sleep apnea (OSA) with retropalatal collapse.

METHODS

Patients were randomly categorized into two groups: the first group for whom bilateral SSS were performed and a second group for whom bilateral DSS were done. Snoring on the basis of the visual analog scale (VAS), Epworth Sleepiness Scale (ESS), apnea hypopnea index (AHI), lowest O saturation were assessed preoperatively and 6 months postoperatively in all patients.

RESULTS

DSS provided significantly more retroplatal space (p = 0.0137) and less snoring score (p = 0.0005). While no significance difference between SSS and DSS as regard inter pillar distance (p = 0.0985), AHI (p = 0.1677), ESS (p = 0.4094), and lowest O saturation (p = 0.0839).

CONCLUSION

Both SSS and DSS are simple, rapid, bloodless and effective procedures for treating OSA (in patients with retropalatal collapse) with no temporary or persistent postoperative complications. Adding the second suture in DSS could significantly enlarge more retropalatal space and reduce more snoring scale than SSS.

摘要

目的

比较采用双侧单腭悬吊缝线(SSS)与双侧双悬吊缝线(DSS)进行扩宽咽成形术治疗软腭后塌陷所致阻塞性睡眠呼吸暂停(OSA)特定病例的效果。

方法

将患者随机分为两组:第一组实施双侧SSS,第二组实施双侧DSS。对所有患者在术前及术后6个月基于视觉模拟量表(VAS)、爱泼沃斯思睡量表(ESS)、呼吸暂停低通气指数(AHI)、最低血氧饱和度评估打鼾情况。

结果

DSS提供了显著更多的软腭后间隙(p = 0.0137)且打鼾评分更低(p = 0.0005)。而在柱间距离(p = 0.0985)、AHI(p = 0.1677)、ESS(p = 0.4094)及最低血氧饱和度(p = 0.0839)方面,SSS与DSS之间无显著差异。

结论

SSS和DSS都是治疗OSA(软腭后塌陷患者)的简单、快速、无血且有效的手术方法,术后无短期或长期并发症。与SSS相比,DSS增加第二条缝线可显著扩大更多软腭后间隙并降低更多打鼾程度。

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