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目的:进一步探讨阻塞性睡眠呼吸暂停低通气综合征(OSAHS)患者行UPPP的疗效,以及UPPP软腭切除范围、OSAHS患者低氧血症术后改善的客观标准。方法:对27例正常成人(正常组)及34例OSAHS患者(OSAHS组)术前、术后15~20 d进行腭咽部解剖测量及血常规检查。对术前、术后资料进行统计学分析。结果:正常组与OSAHS组的软腭长、咽侧距、腭侧距、红细胞(RBC)、血红蛋白(HGB)及红细胞比积(HCT)比较,均差异有统计学意义(均P<0.01)。OSAHS组术后RBC、HGB、HCT的值明显低于术前(均P<0.01)。OSAHS组仅HGB与最低血氧饱和度(SaO2)有明显的负相关性(r=0.580 0,P<0.01)。术后6个月按主观症状改善显效率为74.2%,总有效率为96.8%,其中改善最明显的症状为白天嗜睡,1例术后鼻咽返流。术后随访6个月。结论:OSAHS术后改善最明显的症状是白天嗜睡,重度OSAHS患者需综合治疗。软腭切除范围不能超过1.5 cm;HGB可初步作为评定OSAHS低氧血症及术后血氧饱合度改善的一个客观指标。
OBJECTIVE: To further investigate the curative effect of UPPP in patients with obstructive sleep apnea-hypopnea syndrome (OSAHS) and the objective criteria for postoperative improvement of hypoxemia in UPPP soft palate resection and OSAHS patients. Methods: The palatopharyngeal anatomy and blood tests were performed in 27 normal adults (normal group) and 34 OSAHS patients (OSAHS group) before and 15 to 20 days after operation. Preoperative and postoperative data were statistically analyzed. Results: There were significant differences between the normal group and the OSAHS group in the palate length, pharyngeal distance, palatal distance, RBC, HGB and HCT (all P <0.01). The values of RBC, HGB and HCT in OSAHS group were significantly lower than those before operation (all P <0.01). OSAHS group only HGB and minimum oxygen saturation (SaO2) have a significant negative correlation (r = 0.580 0, P <0.01). Subjective symptom improvement at 6 months after operation was markedly effective at 74.2% and total effective rate was 96.8%. The most obvious symptom of improvement was daytime drowsiness and 1 case of postoperative nasopharyngeal reflux. The patients were followed up for 6 months. Conclusion: The most obvious symptom of postoperative OSAHS improvement is daytime drowsiness, and patients with severe OSAHS need comprehensive treatment. Soft palate resection range can not exceed 1.5 cm; HGB can be used as a preliminary assessment of OSAHS hypoxemia and postoperative oxygen saturation improved an objective indicator.