摘要
目的 探讨采用等离子低温射频术对轻症阻塞性睡眠呼吸暂停低通气综合征 (OSAHS)患者行软腭部消融的临床疗效。方法 选择 18例轻度OSAHS患者 ,分别于术前和术后 8周行多导睡眠图等检查 ,比较软腭长度、悬雍垂长度、鼾声评级及Epworth嗜睡程度评分 ,观察术中、后的主要反应。结果 患者射频治疗前和治疗 8周后多导睡眠参数比较显示 :治疗后Ⅰ +Ⅱ期睡眠 /总睡眠时间 (TST) (% )明显缩短 ,Ⅲ +Ⅳ期睡眠 /TST (% )明显延长、睡眠效率 (TST/总记录时间 % )及最低脉氧饱和度 (LSpO2 )均显著提高 (P <0 .0 5 ) ;此外 ,呼吸暂停低通气指数的减低以及打鼾时间 /TST的缩短均较治疗前相差非常显著 (P <0 .0 1)。患者射频治疗 8周后软腭长度及悬雍垂长度的缩短及鼾声评级的降低均较治疗前相差非常显著 (P <0 .0 1)。Epworth嗜睡程度评分亦较治疗前明显降低 (P <0 .0 1)。软腭射频术后对疼痛、讲话及吞咽的影响的评分标准 ,18例患者术后 1～ 3天对以上三项的影响基本在轻度以内 ,术后 7天时影响又较 1～ 3天时进一步改善。结论 等离子低温射频消融对于轻度OSAHS患者具有较明显的近期疗效 ,且安全无明显不良反应。其远期疗效尚有待观察。
Objective To investigate the clinical efficacy of soft palate ablation with plasma radiofrequency(RF) at low temperature on mild obstructive sleep apnea hypopnea syndrome(OSAHS).Method 18 patients with mild OSAHS were selected.The polysomnography examinations were carried out before and 8 weeks after RF operation respectively.The length of soft palate and uvula,snoring scale and Epworth sleepiness score(ESS) were also compared.The main adverse reactions were observed during and after the operation.Results Comparison of polysomnography parameters before and 8 weeks after RF operation showed that Ⅰ+Ⅱ phase sleep/total sleep time(TST)(%) shortened significantly,Ⅲ+Ⅳ phase sleep/TST(%) prolonged,sleep efficiency[TST/total recording time(%)] and the lowest pulse oxygen saturation improved significantly(all P <0.05 ).In addition,there were significant differences in the decrease of apnea hypopnea index and the shortened rate of snoring time/TST before and after operation(all P <0.01).8 weeks after treatment,the length of soft palate and uvula shortened,snoring scale and ESS decreased significantly( P <0.01).The observation of effects of soft palate RF operation on pain,speech and swallow revealed that the influence of RAF was mild 1～3 days after operation,and an obvious further improvement could be detected 7 days after operation.Conclusions Plasma RF ablation at low temperature is effective to mild OSAHS at least in a short term.This treatment is safe without obvious adverse reactions.However,its long-term efficacy is expected to be further observed.
出处
《现代诊断与治疗》
CAS
2003年第4期236-238,共3页
Modern Diagnosis and Treatment
