摘要
目的 :比较手术、等离子体消融及持续经鼻正压通气对阻塞性睡眠呼吸暂停综合征 (OSAS)的疗效 ,探讨最佳治疗途径。方法 :将 45 0例OSAS患者分为 3组 ,其中手术组 3 68例〔包括悬雍垂腭咽成形术 (UPPP)3 0 2例 ,UPPP加舌根部分切除术 (PERT) 4 9例 ,UPPP加下鼻甲部分切除术 (PIT) 11例 ,UPPP加PERT加PIT 6例〕 ;等离子体消融 (CPS)组 65例 ;鼻腔持续正压通气 (nCPAP)组 2 5例 ,其中 17例为首选治疗 ,8例为手术失败后治疗。结果 :nCPAP组的近远期疗效 ( 95 .2 3 %及 83 .3 3 % )均高于手术组及CPS组 ,手术组与CPS组的近期疗效相近 ,分别为 86.3 9%及 78.0 4%。手术组的远期 ( 1～ 3年 )疗效尚达不到 5 0 % ,并随时间延长而继续下降 ,且具有一定的危险性和并发症。CPS组和nCPAP组的副作用小 ,无明显并发症。结论 :OSAS的治疗应趋向于安全、简单、有效 ,并易于患者接受 ,重度患者应接受nCPAP或较简单安全的手术治疗 ,UPPP、CPS及nCPAP均对中轻度患者有较好的疗效 ,可由患者与医生根据具体情况作出适当的选择。
Objective:To explore the most appropriate treatment through comparing surgery,coblator plasma surgery (CPS) and nasal continuous positive airway pressure (nCPAP) in obstructive sleep apnea syndrome (OSAS).Method:Four hundred and fifty cases were retrospectively analyzed,368 patients were operated by uvuloplatopharyngoplasty (UPPP),parcial excision of root of tongue and/or parcial inferior turbinectomy.CPS were performed in 65 patients and 25 cases were accepted the nCPAP.Among them,17 were the first selection and 8 were the second selection after operation failure.Result:The outcomes of near-term (3～6 monthes) and long-term (1～3 years) in CPAP group are 95.23% and 83.33%,higher than surgery and CPS group.In the near-term result,surgery group is similar to CPS group ( 86.39% and 78.04%).The long-term effictive of surgery group is lower than 50% and become worse with the time passed.And surgery may be accompaned with some dangerous and complications afer operation.But the side effect in CPS and nCPAP is very little.Conclusion:The treatment of OSAS is developing to safty,simple and acceptable.nCPAP and some simple safely surgery are fitted in serious patients.UPPP,CPS and nCPAP have good effect in light and middle patients.The long-term effect of CPS should still be observed in future.
出处
《临床耳鼻咽喉科杂志》
CSCD
北大核心
2003年第3期159-160,共2页
Journal of Clinical Otorhinolaryngology
