Han J B, Luo Z H, Dong J, Wang Y, Hua Q Q
Department of Otorhinolaryngology Head and Neck Surgery, Renmin Hospital of Wuhan University, Wuhan 430060, China.
Zhonghua Er Bi Yan Hou Tou Jing Wai Ke Za Zhi. 2023 Oct 7;58(10):959-965. doi: 10.3760/cma.j.cn115330-20221202-00725.
To study the efficacy of Barbed reposition pharyngoplasty (BRP) combined with Han-Uvulopalatopharyngoplasty (H-UPPP) in surgical treatment of OSAHS patients. OSAHS patients admitted to our department from June 2021 to February 2022 who met the surgical enrollment criteria were divided into two groups by surgical procedure: H-UPPP operation group [Control group, 47 cases, including 42 males and 5 females, aged 18-64 (37.77±11.65)years, and H-UPPP+BRP group [Study group, 48 cases, including 45 males and 3 females, aged 23-60 (39.10±9.86) years]. The surgical efficacy 6 months after operation was retrospectively analyzed. Meanwhile, the relationship between the surgical efficacy and modified Friedman pharyngeal anatomical stages was analyzed. The postoperative pain VAS score at first 3 days and the incidence of foreign body sensation in pharynx after 6 months of operation were compared between the two groups. Statistical analysis was conducted by SPSS 23.0. There were no significant differences in gender, age, BMI, Friedman pharyngeal anatomical stages, ESS score, AHI and LSpO between the two groups, preoperatively (0.05). There was significant difference between the two groups in ratio of cumulative time of oxygen saturation below 90% to total sleep time(CT90), preoperatively. Surgical efficacy of H-UPPP operation group was 48.9% (23/47), while H-UPPP+BRP operation group was 70.8% (34/48), which was statistically significant (=4.74, =0.029). H-UPPP+BRP group seemed to have a higher surgical efficacy than H-UPPP group in patients with Friedman Ⅱb (87% 61.9%) and Ⅲ stage (44.4% 15%), but there was no statistically significant difference (0.05). H-UPPP+BRP group had a higher pain VAS score in first three days (=-3.10, =0.003), also had higher incidence of pharyngeal foreign body sensation after 6 months of operation (=4.727, =0.030). In the surgical treatment of OSAHS patients, the overall efficacy of BRP combined H-UPPP surgery is higher than that of H-UPPP surgery alone. It may be more suitable for OSAHS patients with modified Friedman type Ⅱb and type Ⅲ stage.
探讨倒刺复位咽成形术（BRP）联合韩氏悬雍垂腭咽成形术（H-UPPP）治疗阻塞性睡眠呼吸暂停低通气综合征（OSAHS）患者的疗效。将2021年6月至2022年2月我院收治的符合手术纳入标准的OSAHS患者按手术方式分为两组：H-UPPP手术组[对照组，47例，其中男性42例，女性5例，年龄18-64岁（37.77±11.65）岁]，H-UPPP+BRP组[研究组，48例，其中男性45例，女性3例，年龄23-60岁（39.10±9.86）岁]。回顾性分析术后6个月的手术疗效。同时，分析手术疗效与改良Friedman咽解剖分期的关系。比较两组术后前3天的疼痛视觉模拟评分（VAS）及术后6个月咽部异物感发生率。采用SPSS 23.0进行统计学分析。两组患者术前性别、年龄、体重指数（BMI）、Friedman咽解剖分期、嗜睡评分（ESS）、呼吸暂停低通气指数（AHI）及最低血氧饱和度（LSpO）比较，差异均无统计学意义（P>0.05）。两组患者术前氧饱和度低于90%的累计时间占总睡眠时间的比例（CT90）比较，差异有统计学意义。H-UPPP手术组手术有效率为48.9%（23/47），H-UPPP+BRP手术组为70.8%（34/48），差异有统计学意义（χ²=4.74，P=0.029）。在FriedmanⅡb期（87%比61.9%）和Ⅲ期（44.4%比15%）患者中，H-UPPP+BRP组的手术有效率似乎高于H-UPPP组，但差异无统计学意义（P>0.05）。H-UPPP+BRP组术后前3天的疼痛VAS评分更高（t=-3.10，P=0.003），术后6个月咽部异物感发生率也更高（χ²=4.727，P=0.030）。在OSAHS患者的手术治疗中，BRP联合H-UPPP手术的总体疗效高于单纯H-UPPP手术。它可能更适合改良FriedmanⅡb型和Ⅲ期的OSAHS患者。
