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目的提高对阻塞性睡眠呼吸暂停低通气综合征(OSAHS)临床特征的认识和诊断治疗水平。方法对我院2000~2004年就诊的OSAHS 40例患者治疗前后用多导睡眠扫描仪(PSG)和24h有纸记录的动态心电图监测,并采用腭垂腭咽成形术(UPPP)等手术治疗。以术后睡眠呼吸暂停低通气指数<20次/h,并且较术前下降≥50%,临床症状明显减轻为成功。结果总有效率77.5%(31例),其中成功率37.5%(15例),显效27.5%(11例),有效12.5%(5例);无效22.5%(9例),78.2%(18/23)的心律恢复正常。结论手术矫正引起上呼吸道阻塞的器质性病变,使呼吸紊乱得到有效缓解,有助于及时纠正OSAHS的病理生理改变、延缓病情发展,减少心血管病的发生、改善病人预后。无明显舌体肥厚,伴有扁桃体肥大的OSAHS,UPPP手术使呼吸紊乱得到有效缓解是UPPP治疗的最佳适应证。
Objective To improve the understanding of the clinical features of obstructive sleep apnea-hypopnea syndrome (OSAHS) and the level of diagnosis and treatment. Methods Forty patients with OSAHS treated in our hospital from 2000 to 2004 were monitored with polysomnography (PSG) and paper recording 24h dynamic electrocardiogram (ECG) before and after treatment. The patients were treated with paraplaspid pharyngolaryngoplasty (UPPP). Postoperative sleep apnea hypopnea index <20 times / h, and more than 50% reduction compared with preoperative, significant reduction of clinical symptoms was successful. Results The total effective rate was 77.5% (31 cases), including 37.5% (15 cases), 27.5% (11 cases), 12.5% (5 cases), 22.5% (9 cases), 78.2% 23) the heart rate returned to normal. Conclusions Surgical correction of organic diseases caused by upper airway obstruction can effectively relieve the respiratory disturbance and help to timely correct the pathophysiological changes of OSAHS, delay the progression of the disease, reduce the occurrence of cardiovascular diseases and improve the prognosis of patients. No obvious tongue hypertrophy, with tonsil hypertrophy OSAHS, UPPP surgery to effectively alleviate respiratory disorders is the best indications of UPPP treatment.