改良低温射频消融术治疗阻塞性睡眠呼吸暂停低通气综合征多平面手术的疗效评估：一项开放性介入研究。
Evaluation of modified coblation endoscopic lingual lightening in multilevel surgery for obstructive sleep apnea hypopnea syndrome: an open intervention study.
机构信息
Department of Otorhinolaryngology Head and Neck Surgery, The First Affiliated Hospital of Naval Medical University, No. 168, Changhai Rd, Shanghai City, 200433, China.
Department of Medical Imaging, The First Affiliated Hospital of Naval Medical University, Shanghai City, China.
出版信息
Sleep Breath. 2024 May;28(2):647-656. doi: 10.1007/s11325-023-02912-2. Epub 2023 Oct 16.
PURPOSE
To evaluate the efficacy and safety of modified coblation endoscopic lingual lightening to address retrolingual obstruction in multilevel surgery for obstructive sleep apneae (OSA).
METHODS
Patients with OSA due to retropalatal and retrolingual obstructions were enrolled. Group 1 consisted of patients who underwent modified coblation endoscopic lingual lightening combined with H-uvulopalatopharyngoplasty, while group 2 comprised patients treated by H-uvulopalatopharyngoplasty alone. Objective parameters and subjective evaluations were recorded preoperatively and at 6 months postoperatively.
RESULTS
The mean (standard deviation) apnea-hypopnea index (AHI) declined from 51.5 (18.9) to 14.3 (7.2) in group 1, and from 51.7 (15.8) to 28.5 (16.9) in group 2. The mean (standard deviation) percentage change in AHI was higher in group 1 than in group 2 (73.2 [10.9] vs. 48.9 [22.4], P < 0.01). The surgical response rate differed significantly between groups 1 and 2 (88.5 [23/26] vs. 46.7 [14/30], P < 0.01). Other outcomes, including the lowest oxygen saturation, Epworth Sleepiness Scale score, snoring visual analog scale score, and subjective improvement rate, were also significantly better in group 1 than in group 2.
CONCLUSION
Without increasing complications, modified coblation endoscopic lingual lightening significantly improved surgical outcomes as part of multilevel surgery in patients with OSA due to multilevel obstruction.
目的
评估改良低温射频消融舌根减容术治疗多平面手术中舌根后气道阻塞（OSA）的疗效和安全性。
方法
纳入因软腭后区和舌根后气道阻塞而患有 OSA 的患者。第 1 组患者接受改良低温射频消融舌根减容术联合 H-悬雍垂腭咽成形术，第 2 组患者仅接受 H-悬雍垂腭咽成形术。记录术前和术后 6 个月的客观参数和主观评估结果。
结果
第 1 组的平均（标准差）呼吸暂停低通气指数（AHI）从 51.5（18.9）降至 14.3（7.2），第 2 组从 51.7（15.8）降至 28.5（16.9）。第 1 组 AHI 的平均（标准差）百分比变化高于第 2 组（73.2[10.9]比 48.9[22.4]，P<0.01）。第 1 组和第 2 组之间的手术反应率差异有统计学意义（88.5[23/26]比 46.7[14/30]，P<0.01）。第 1 组的其他结果，包括最低血氧饱和度、Epworth 嗜睡量表评分、打鼾视觉模拟量表评分和主观改善率，也明显优于第 2 组。
结论
改良低温射频消融舌根减容术在多平面手术中作为多平面阻塞性睡眠呼吸暂停患者的一部分，在不增加并发症的情况下，显著改善了手术结果。
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