摘要
目的 比较低温等离子融切辅助悬雍垂腭咽成形术（UPPP）与常规UPPP治疗阻塞性睡眠呼吸暂停低通气综合征（ OSAHS）的手术并发症发生情况,探讨OSAHS外科治疗更安全、更微创、并发症更少的手术方式.方法 回顾性对照分析1995至2010年以来采用常规UPPP方法（简称常规组）以及低温等离子融切辅助UPPP的方法（简称等离子组）治疗OSAHS患者手术并发症的情况,其中,常规组451例,等离子组323例.组间并发症发生率差异比较采用卡方检验和Fisher精确概率法.结果 严重手术并发症发生率常规组3.77％（ 17/451）明显高于等离子组0.62％（2/323）,x2=7.800,P＜0.01.可以自行恢复的短期并发症发生率常规组60.98％ （275/451）低于等离子组90.40％ （292/323）,x2=83.186,P ＜0.01；两组患者中难以自行恢复的长期并发症分别为9/451和2/323,差异无统计学意义（P＞0.05）.两组患者窒息并发症发生率差异无统计学意义（P＞0.05）；但原发性出血的发生率等离子组为0,明显低于常规组（3.99％,18/451）,x2=12.133,P＜0.01;继发性出血、暂时性腭咽关闭不全、咽喉异物感并发症的发生率,等离子组分别为8.05％、12.69％和68.42％,高于常规组（分别为3.77％、3.33％和51.00％）,差异均有统计学意义（P值均＜0.01）；而永久性腭咽关闭不全、鼻咽狭窄及闭锁、味觉改变及喉痒咳嗽并发症,两组间差异均无统计学意义（P值均＞0.05）.结论 低温等离子融切辅助UPPP较常规UPPP治疗OSAHS更为安全,严重并发症和长期并发症更少.
Objective To compare the operative effectivity and incidence of postoperative complication between conventional uvulopalatopharyngoplasty （UPPP） and modified coblation assisted UPPP （M-CAUP） in treating patients with obstructive sleep apnea-hypopnea syndrome （OSAHS）.And to explore the more effective,safer and minimally invasive operative method in surgical therapy of OSAHS.Methods It was a controlled trial.A retrospective analysis was made on surgical complications of conventional UPPP and of M-CAUP performed on OSAHS patients from 1995 to 2010.There were 451 patients in UPPP group and 323 patients in M-CAUP group.x2 test and Fisher＇s Exact test were used in statistical analysis.Results The incidence of serious surgical complications was higher in conventional UPPP group （3.77%,17/451） than that in M-CAUP group （0.62%,2/323）,x2 =7.800,P 〈 0.01,while the incidence of short-term complications was higher in M-CAUP group （90.40%,292/323 ） than that in conventional UPPP group （60.98%,275/451）,x2 =83.186,P 〈 0.01.The difference of long-term complications was not statistically significant between M-CAUP group and conventional UPPP group （P =0.1331,Fisher Exact test）.There was no significant difference in incidence of asphyxia between M-CAUP group and conventional UPPP group （P 〈 0.01,Fisher Exact test）.However,the incidence of post-operative primary hemorrhage was obviously lower in M-CAUP group than that in conventional UPPP group （ 3.99%,18/451 ）,x2 =12.133,P 〈 0.01.While the incidence of delayed hemorrhage,temporal velopharyngeal insufficiency,and foreign body sensation at pharynx were higher in M-CAUP group （8.05%, 12.69%, 68.42%,respectively） than that in conventional UPPP group （3.77%,3.33%,51.00%,respectively） P 〈0.01,respectively.There was no significant difference in incidence of permanent velopharyngeal insufficiency,stenosis of nasopharynx and nasopharyngeal atresia,alteration of taste,throat itch and coughing.Conclusion Compared to the conventional
出处
《中华耳鼻咽喉头颈外科杂志》
CAS
CSCD
北大核心
2012年第2期101-106,共6页
Chinese Journal of Otorhinolaryngology Head and Neck Surgery
关键词
手术中并发症
手术后并发症
消融技术
耳鼻喉外科手术
睡眠呼吸暂停
阻塞性
Intraoperative complications
Postoperative complications
Ablation techniques
Otorhinolaryngologic surgical procedures
Sleep apnea, obstructive
