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悬雍垂腭咽成形术后睡眠呼吸暂停的短期与长期术后评估比较。

Comparison between short-term and long-term post-operative evaluation of sleep apnoea after uvulopalatopharyngoplasty.

作者信息

Lu S J, Chang S Y, Shiao G M

机构信息

Department of Otolaryngology, Veterans General Hospital, National Yang Ming Medical College, Taipei, Taiwan.

出版信息

J Laryngol Otol. 1995 Apr;109(4):308-12. doi: 10.1017/s0022215100129998.

DOI:10.1017/s0022215100129998
PMID:7782686
Abstract

For a long time uvulopalatopharyngoplasty (UPPP) has been used to treat the obstructive sleep apnoea syndrome (OSAS). The diverse surgical effects, the inadequate understanding of operation effect consistency, the possibility of disease progression, and the few reported papers for long-term evaluation after UPPP aroused our interest in designing this study. Fifteen OSAS patients who had undergone UPPP with pre-operative, initial post-operative and long-term post-operative polysomnographic studies were included in this study. Long-term post-operative polysomnography was undertaken more than five years after surgery. The polysomnographic evaluations included respiratory disturbance index (RDI), duration of saturation SaO2 < 85 per cent (DOS), and the lowest O2 saturation (LOS). Amongst them, 10 patients with initial post-operative RDI reduction > 50 per cent were considered responders. In these responders, the long-term follow-up results of all three parameters showed improvement compared to the pre-operative data. In a comparison between the initial and long-term post-operative sleep study results, LOS and DOS showed no significant difference. However, the long-term post-operative RDI result became significantly worse. More than 80 per cent of all cases had subjective symptomatic improvement in the long-term post-operative evaluation. The subjective improvement after operation is not adequately correlated to the polysomnographic result. We suggest that long-term follow-up for patients after UPPP is necessary.

摘要

长期以来,悬雍垂腭咽成形术(UPPP)一直用于治疗阻塞性睡眠呼吸暂停综合征(OSAS)。该手术效果多样,对手术效果一致性的认识不足,疾病有进展的可能性,且关于UPPP术后长期评估的报道较少,这些因素激发了我们开展本研究的兴趣。本研究纳入了15例接受UPPP手术的OSAS患者,这些患者术前、术后初期及术后长期均进行了多导睡眠图检查。术后长期多导睡眠图检查在手术五年后进行。多导睡眠图评估包括呼吸紊乱指数(RDI)、血氧饱和度(SaO2)<85%的持续时间(DOS)以及最低血氧饱和度(LOS)。其中,10例术后初期RDI降低>50%的患者被视为有效反应者。在这些有效反应者中,与术前数据相比,所有三个参数的长期随访结果均有所改善。在术后初期与长期睡眠研究结果的比较中,LOS和DOS无显著差异。然而,术后长期RDI结果明显变差。在术后长期评估中,超过80%的病例主观症状有改善。术后主观改善与多导睡眠图结果的相关性不足。我们建议对UPPP术后患者进行长期随访是必要的。

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J Laryngol Otol. 1995 Apr;109(4):308-12. doi: 10.1017/s0022215100129998.
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引用本文的文献

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J Clin Med. 2020 Sep 25;9(10):3089. doi: 10.3390/jcm9103089.
2
Is uvulopalatopharyngoplasty still an option for the treatment of obstructive sleep apnea?悬雍垂腭咽成形术仍是治疗阻塞性睡眠呼吸暂停的选择吗?
Eur Arch Otorhinolaryngol. 2013 Feb;270(2):549-54. doi: 10.1007/s00405-012-2042-3. Epub 2012 May 13.
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Long-term efficacy of submucosal uvulopalatopharyngoplasty for obstructive sleep apnea syndrome.
悬雍垂腭咽成形术治疗阻塞性睡眠呼吸暂停低通气综合征的长期疗效。
Eur Arch Otorhinolaryngol. 2012 Sep;269(9):2069-74. doi: 10.1007/s00405-011-1919-x. Epub 2012 Jan 10.
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A critical evaluation of surgery for sleep disordered breathing.对睡眠呼吸障碍手术的批判性评估。
GMS Curr Top Otorhinolaryngol Head Neck Surg. 2006;5:Doc04. Epub 2006 Oct 5.
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Reconstructive procedures for disturbed functions within the upper airway: pharyngeal breathing/snoring.上气道功能紊乱的重建手术:咽呼吸/打鼾。
GMS Curr Top Otorhinolaryngol Head Neck Surg. 2005;4:Doc08. Epub 2005 Sep 28.
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[Guideline: Treatment of obstructive sleep apnea in adults].[指南:成人阻塞性睡眠呼吸暂停的治疗]
HNO. 2009 Nov;57(11):1136-56. doi: 10.1007/s00106-009-2013-1.