摘要目的 探讨改良悬雍垂腭咽成形术联合舌根射频消融治疗阻塞性睡眠呼吸暂停低通气综合征(OSAHS)的疗效.方法 分析62例阻塞平面在口咽和舌根的中重度OSAHS患者临床资料,在术前充分告知研究事宜的情况下患者自主选择人组,对照组30例行单纯改良悬雍垂腭咽成形术,试验组32例在行改良悬雍垂腭咽成形术的同时行舌根射频消融,比较两组患者的临床疗效.请给出具体的统计学分析方法.结果 两组患者术前一般情况比较差异无统计学意义,术后试验组总有效率为71.9％高于对照组的46.7％,差异有统计学意义(x2=4.09,P＜0.05);术后对照组呼吸暂停低通气指数(AHI)为(19.4±8.1)次/h、最低血氧饱和度(LSaO2)为0.767±0.052,术后试验组AHI为(17.8±7.8)次/h、LSaO2为0.790±0.059,两组与术前比较差异均有统计学意义(P＜0.001).试验组术后口咽腔最小前后径为(10.6±2.4) mm较术前(9.9±2.2) mm扩大,差异有统计学意义(t=2.64,P＜0.05),对照组术后口咽腔最小前后径为(10.0±2.4) mm较术前(9.9±2.5) mm改善不显著,差异无统计学意义(P＞0.05).对照组和试验组相比术后AHI、LSaO2、口咽腔最小前后径差异无统计学意义(P＞0.05).结论 对于阻塞平面在口咽和舌根的中重度OSAHS患者同时行改良悬雍垂腭咽成形术和舌根射频消融术,手术疗效明确.

abstractsObjective To investigate the effect of H-uvulopalatopharyngoplasty (H-UPPP) combined with tongue base radiofrequency ablation in the treatment of obstructive sleep apnea hypopnea syndrome(OSAHS).Methods Sixty-two patients with moderate or severe OSAHS,whose obstructive plane located in the oropharynx and tongue base were divided into two groups two groups according to the patient's independent choice under the condition of fully informed before the operation.The control group of 30 cases underwent H-UPPP,while the experimental group of 32 patients underwent improved H-UPPP and tongue base radiofrequency.The clinical efficacy between the two groups was compared.Results There was no significant difference between the two groups before operation.After the operation,the total effective rate of the experimental group was 71.9％,significantly higher than that of the control group (46.7％,x2 =4.09,P ＜ 0.05),the difference was statistically significant.After operation,in the control group,AHI was (19.4 ±8.1)/h,LSaO2 was 0.767 ±0.052.In the experimental group,AHI was (17.8 ±7.8)/h,LSaO2 was 0.790 ± 0.059.There was significant difference in both groups before and after surgery (P ＜ 0.001),with statistical significance.In the experimental group,after operation,the minimum diameter of oropharyngeal cavity was (10.6 ± 2.4) mm,there was obvious increase compared with the diameter of oropharyngeal cavity (9.9 ± 2.2) mm before operation,the difference was statistically significant (t =2.64,P ＜ 0.05).In the control group,after operation,the minimum diameter of oropharyngeal cavity was(10.0 ± 2.4) mm,there was no obvious increase compared with the diameter of oropharyngeal cavity (9.9 ± 2.5) mm before operation,the difference was not statistically significant (P ＞ 0.05).Compared between control group and experimental group,the differences of AHI,LSaO2,the minimum anteroposterior diameter of oropharyngeal cavity before and after operation were not statistically significant (P ＞ 0.05).Conclusion The effect of same time H-UPPP and radiofrequency ablation surgery is definitive.