Wetmore S J, Scrima L, Snyderman N L, Hiller F C
Laryngoscope. 1986 Jul;96(7):738-41. doi: 10.1288/00005537-198607000-00007.
Uvulopalatopharyngoplasty (UPPP) is an operation that is frequently performed for the treatment of obstructive sleep apnea (OSA). While UPPP usually eliminates or decreases snoring and often reduces excessive daytime sleepiness, the decrease in the number of episodes of apnea and hypopnea, and the improvement in oxygen saturation (SaO2) have been less predictable. We compared preoperative and postoperative polysomnography (PSG) in 27 patients with OSA and found that no single PSG parameter could accurately reflect the changes in respiration seen after UPPP. We suggest that a combination of indices including the apnea index, the apnea and hypopnea index, the frequency and severity of decreases in SaO2, and the lowest SaO2 be used to assess the effect of UPPP. Using this combination we determined that 30% of our patients were markedly improved, 33% were somewhat improved, and 37% were unimproved. To rely solely on the patient's subjective improvement often results in overestimating the therapeutic results of surgery, whereas to rely only on one PSG parameter may underestimate or overestimate the degree of improvement.
悬雍垂腭咽成形术（UPPP）是一种常用于治疗阻塞性睡眠呼吸暂停（OSA）的手术。虽然UPPP通常能消除或减轻打鼾，且常常能减轻日间过度嗜睡，但呼吸暂停和呼吸不足发作次数的减少以及血氧饱和度（SaO2）的改善情况却较难预测。我们比较了27例OSA患者术前和术后的多导睡眠图（PSG），发现没有单一的PSG参数能准确反映UPPP术后呼吸的变化。我们建议使用包括呼吸暂停指数、呼吸暂停和呼吸不足指数、SaO2下降的频率和严重程度以及最低SaO2在内的指标组合来评估UPPP的效果。通过使用这种组合，我们确定30%的患者有明显改善，33%的患者有一定改善，37%的患者无改善。仅依靠患者的主观改善往往会高估手术的治疗效果，而仅依靠一个PSG参数可能会低估或高估改善程度。
