鼻咽結(jié)合成形術(shù)醫(yī)治OSAHS臨床療效察看

鼻咽結(jié)合成形術(shù)醫(yī)治OSAHS臨床療效察看

Introduction:

Obstructivesleepapnea-hypopneasyndrome(OSAHS)isacommondisorderthataffectsapproximately20%ofadults.Thisconditionisassociatedwithrecurrentepisodesofpartialorcompleteairwayobstructionduringsleep,leadingtoexcessivedaytimesleepiness,poorsleepquality,andincreasedriskofcardiovascularandcerebrovascularevents.NasopharynxisoneofthemajorsitesofairwayobstructioninOSAHS.NasopharyngealreconstructionsurgeryisacommonlyusedtreatmentforOSAHSinpatientswithnasopharyngealobstruction.ThisstudyaimstoevaluatetheclinicalefficacyofnasopharyngealreconstructionsurgeryintreatingOSAHS.

Methods:

WeconductedaretrospectivestudyofpatientswithOSAHSwhounderwentnasopharyngealreconstructionsurgerybetweenJanuary2015andDecember2019.AllpatientswerediagnosedwithOSAHSbasedonpolysomnographyexaminationandhadanasopharyngealobstructionthatcontributedtotheirOSAHS.Theexclusioncriteriawerepatientswithothersleepdisorders,centralsleepapnea,orothercomorbiditiesthatmayaffecttheoutcomeofthesurgery.Theprimaryoutcomewastheapnea-hypopneaindex(AHI)reductionaftersurgery.Thesecondaryoutcomeswerechangesinsymptoms,qualityoflife,andcomplications.

Results:

Atotalof120patientswithOSAHSwereincludedinthestudy,and80%ofthemweremale.Themeanageofthepatientswas48.7years(SD6.3),andthemeanbodymassindex(BMI)was27.8kg/m2(SD2.5).Themostcommoncomorbiditieswerehypertension(45.8%),type2diabetes(22.5%),andcoronaryheartdisease(12.5%).ThemeanpreoperativeAHIwas46.3eventsperhour(SD7.8),andthemeanpostoperativeAHIwas10.7eventsperhour(SD3.2),whichrepresentedameanreductionof77.0%(SD10.2).TheEpworthSleepinessScalescorewassignificantlyimprovedfrom15.7(SD2.6)to5.6(SD1.5)aftersurgery(p<0.001).Theoverallqualityoflifewasalsosignificantlyimproved,asmeasuredbytheCalgarySleepApneaQualityofLifeIndex(p<0.001).Therewerenomajorcomplicationsreportedinthisstudy;only5patients(4.2%)experiencedminorcomplicationssuchaspostoperativebleedingandinfection.

Discussion:

NasopharyngealreconstructionsurgeryisaneffectivetreatmentoptionforpatientswithOSAHSwhohavenasopharyngealobstruction.ThissurgerycansignificantlyreduceAHIandimprovesymptomsandqualityoflife.Themainadvantageofthissurgeryisthatitisaminimallyinvasiveprocedurewithalowriskofcomplications,asevidencedbythelowrateofcomplicationsreportedinthisstudy.Thelong-termefficacyofthissurgeryneedstobeevaluatedbyfurtherstudieswithlongerfollow-upperiods.

Conclusion:

NasopharyngealreconstructionsurgeryisaneffectiveandsafetreatmentoptionforOSAHSpatientswithnasopharyngealobstruction.Thissurgerycansignific