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对于阻塞性睡眠呼吸暂停患者,外侧咽成形术与传统悬雍垂腭咽成形术的比较:系统评价与荟萃分析

Lateral pharyngoplasty vs. traditional uvulopalatopharyngoplasty for patients with OSA: systematic review and meta-analysis.

作者信息

Maniaci Antonino, Di Luca Milena, Lechien Jerome René, Iannella Giannicola, Grillo Calogero, Grillo Caterina Maria, Merlino Federico, Calvo-Henriquez Christian, De Vito Andrea, Magliulo Giuseppe, Pace Annalisa, Vicini Claudio, Cocuzza Salvatore, Bannò Vittoria, Pollicina Isabella, Stilo Giovanna, Bianchi Alberto, La Mantia Ignazio

机构信息

Department of Medical and Surgical Sciences and Advanced Technologies "GF Ingrassia," ENT Section, University of Catania, Via Santa Sofia, 95100, Catania, Italy.

Department of Human Anatomy and Experimental Oncology, Faculty of Medicine, UMONS Research Institute for Health Sciences and Technology, University of Mons (UMons), Mons, Belgium.

出版信息

Sleep Breath. 2022 Dec;26(4):1539-1550. doi: 10.1007/s11325-021-02520-y. Epub 2022 Jan 3.

Abstract

OBJECTIVES

To compare the efficacy and success rates of lateral pharyngoplasty techniques (LP) vs. uvulopalatopharyngoplasty (UPPP) among adult patients surgically treated for obstructive sleep apnea.

METHODS

A systematic literature review of the last 20 years' papers was conducted using PubMed/Medline, Embase, Web of Science, Scholar, and the Cochrane Library until April 2021. Only full-text English articles comparing LP and UPPP outcomes in adult patients with objective outcomes were included in the study.

RESULTS

We included 9 articles for a total of 312 surgically treated patients with OSA. LP techniques for obstructive sleep apnea were used on 186 (60%) subjects, while 126 patients (40%) were treated with UPPP. Both surgical procedures resulted in significant improvements in apnea-hypopnea index (AHI), Epworth Sleepiness Scale (ESS) score, and lowest oxygen saturation (LOS) (p < 0.001 in all cases). Although better outcomes were reported with lateral pharyngoplasty, the differences were not significant compared to UPPP post-operative results (p > 0.05 in all cases).

CONCLUSIONS

UPPP and LP are both effective surgical procedures in treating OSA in adults. Although not significant, LPs demonstrated improved post-operative outcomes. However, further evidence comparing the surgical effect on patients with OSA is needed to discriminate post-operative outcomes.

摘要

目的

比较在接受手术治疗的阻塞性睡眠呼吸暂停成年患者中,咽侧成形术(LP)与悬雍垂腭咽成形术(UPPP)的疗效和成功率。

方法

截至2021年4月,使用PubMed/Medline、Embase、Web of Science、Scholar和Cochrane图书馆对过去20年的论文进行了系统的文献综述。该研究仅纳入了比较LP和UPPP在成年患者中客观结局的全文英文文章。

结果

我们纳入了9篇文章,共计312例接受手术治疗的阻塞性睡眠呼吸暂停患者。186例(60%)受试者采用LP技术治疗阻塞性睡眠呼吸暂停,而126例患者(40%)接受了UPPP治疗。两种手术均使呼吸暂停低通气指数(AHI)、爱泼华嗜睡量表(ESS)评分和最低血氧饱和度(LOS)有显著改善(所有病例p < 0.001)。尽管咽侧成形术报告的结果更好,但与UPPP术后结果相比差异不显著(所有病例p > 0.05)。

结论

UPPP和LP都是治疗成人阻塞性睡眠呼吸暂停的有效手术方法。虽然差异不显著,但LP显示出更好的术后结果。然而,需要更多比较手术对阻塞性睡眠呼吸暂停患者治疗效果的证据来区分术后结果。

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