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1
When continuous positive airway pressure (CPAP) fails.当持续气道正压通气（CPAP）治疗失败时。
J Thorac Dis. 2016 Oct;8(10):E1112-E1121. doi: 10.21037/jtd.2016.09.67.
2
Oronasal Masks Require a Higher Pressure than Nasal and Nasal Pillow Masks for the Treatment of Obstructive Sleep Apnea.对于阻塞性睡眠呼吸暂停的治疗，口鼻面罩比鼻罩和鼻枕面罩需要更高的压力。
J Clin Sleep Med. 2016 Sep 15;12(9):1263-8. doi: 10.5664/jcsm.6128.
3
The Effect of Upper Airway Surgery on Continuous Positive Airway Pressure Levels and Adherence: A Systematic Review and Meta-Analysis.上气道手术对持续气道正压通气水平及依从性的影响：一项系统评价与Meta分析
ORL J Otorhinolaryngol Relat Spec. 2016;78(3):119-25. doi: 10.1159/000442023. Epub 2016 Apr 7.
4
The influence of multilevel upper airway surgery on CPAP tolerance in non-responders to obstructive sleep apnea surgery.多级上气道手术对阻塞性睡眠呼吸暂停手术无反应者持续气道正压通气耐受性的影响。
Eur Arch Otorhinolaryngol. 2016 Sep;273(9):2813-8. doi: 10.1007/s00405-015-3865-5. Epub 2015 Dec 29.
5
The effect of nasal surgery on continuous positive airway pressure device use and therapeutic treatment pressures: a systematic review and meta-analysis.鼻腔手术对持续气道正压通气设备使用及治疗压力的影响：一项系统评价与荟萃分析
Sleep. 2015 Feb 1;38(2):279-86. doi: 10.5665/sleep.4414.
6
Obesity and obstructive sleep apnea: pathogenic mechanisms and therapeutic approaches.肥胖与阻塞性睡眠呼吸暂停：发病机制与治疗方法
Proc Am Thorac Soc. 2008 Feb 15;5(2):185-92. doi: 10.1513/pats.200708-137MG.
7
Influence of upper airway narrowing on the effective continuous positive airway pressure level.上气道狭窄对有效持续气道正压水平的影响。
Laryngoscope. 2007 Jan;117(1):82-5. doi: 10.1097/01.mlg.0000244157.73951.f6.
8
Lung volume and continuous positive airway pressure requirements in obstructive sleep apnea.阻塞性睡眠呼吸暂停患者的肺容量和持续气道正压通气需求
Am J Respir Crit Care Med. 2005 Jul 1;172(1):114-7. doi: 10.1164/rccm.200404-552OC. Epub 2005 Apr 7.

上气道手术用于救治患有阻塞性睡眠呼吸暂停（OSA）和肥胖症的“难治性”患者。

Upper airway surgery to rescue the "untitratable" patient with OSA and obesity.

作者信息

Seay Everett G, Mulholland Graeme, Dedhia Raj C

机构信息

Department of Otolaryngology, Emory University School of Medicine, Atlanta, Georgia.

Emory Sleep Center, Emory Healthcare, Atlanta, Georgia.

出版信息

J Clin Sleep Med. 2020 Jan 15;16(1):149-151. doi: 10.5664/jcsm.8142. Epub 2019 Nov 27.

DOI:10.5664/jcsm.8142
PMID:31957643
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC7052995/
Abstract

This is a case report of an 41-year-old male with obesity (body mass index 90 kg/m²), severe obstructive sleep apnea (OSA), and an apnea-hypopnea index of 90 events/h despite high bilevel positive airway pressure (BPAP). He presented to the PAP Alternatives Clinic and underwent tonsillectomy, expansion sphincter pharyngoplasty, and partial uvulectomy to improve positive airway pressure effectiveness. Postoperative BPAP retitration resolved the patient's OSA. The patient is currently using BPAP therapy at home with improvement in both objective and self-reported OSA outcomes.

摘要

这是一例41岁男性患者的病例报告，该患者患有肥胖症（体重指数90kg/m²）、重度阻塞性睡眠呼吸暂停（OSA），尽管使用了高流量双水平气道正压通气（BPAP），但其呼吸暂停低通气指数仍为90次/小时。他前往持续气道正压通气替代疗法诊所就诊，并接受了扁桃体切除术、扩约肌咽成形术和部分悬雍垂切除术，以提高气道正压通气的效果。术后重新调整BPAP解决了患者的OSA问题。患者目前在家中使用BPAP治疗，客观和自我报告的OSA结果均有所改善。