Subjective And Objective Assessment Of Quality Of Life For Coblation-assisting Operation In Patients With Severe OSAHS

ObjectiveTo evaluate the subjective and objective improvement of quality of life in low-temperature plasma-assisted modified uvulopalatopharyngoplasty(H-UPPP) combined with lymphoidectomy in radix linguae and coblation-channeling of the tongue(CCT) treating patients with severe obstructive sleep apnea hypopnea syndrome(OSAHS),and investigate the surgical efficacy.Methods81patients with severe OSAHS were divided treatment group and control group.42patients(male38, female4) underwent low-temperature plasma-assisted H-UPPP combining lymphoidectomy in radix linguae and CCT as observation group,which age26-58years, mean age42.6±9years old and preoperative apnea hypopnea index (AHI) was60.5±17.4, the lowest oxygen saturation (LSaO2)was67±10.7.39patients(male37, female2) underwent H-UPPP as the control group which age24-59years, mean age41.5±8.9years old and preoperative AHI was60.8±16.1, LSaO2was66.1±10.7. The electron nasopharyngolaryngoscopy with the Muller maneuver and CT scanning of upper airway showed that exist at the same time velopharyngeal the lower pharynx obstruction,tongue lymphatic tissue mass hyperplasia accounted for more than the valley1/2,and patients were refused to continuous positive airway pressure(CPAP) treatment,with strong willingness to operation.The Quebec sleep questionnaire(QSQ) and Epworth sleepiness scale (ESS) were surveyed.Taken some records for6months preoperatively and postoperatively, which including AHI, LSaO2and QSQ five dimension score(daytime sleepiness symptoms and signs during the day and night, emotion and ability of social intercourse) and total score and ESS total score. Objective evaluation of cure:AHI<5; effect:AHI<20and the decreasing degree≥50%; effective:AHI decreased≥50%accompanied by the increase of LSaO2. The subjective assessment (1) QSQ:compared some records for6months preoperatively and postoperatively, which including QSQ five dimension score and total score:Value change≥1that there is improvement in quality of life:1-1.49were improvement,1.5-1.99were obviously improved,>2is remarkably improved.(2) ESS:mild≤12,13-17were moderate,18-24were severe. Statistical analysis by SPSS17.0was used. P＜0.05was considered statistically significant.Results1. Comparison between the treatment group and the control group in general: The differences of age,sex,AHI,LSaO2,QSQ five dimension score and total score and ESS total score between the two groups has no statistical significance(P>0.05).2. Comparison of total surgical efficacy between the treatment group and the control group preoperatively and postoperatively.2.1Objective assessment:Postoperative all of indexes were significantly improved (P<0.01),in the treatment group compared with preoperative data.And total surgical efficacy was higher than control group (83.3%vs12.8%,X2=40.225,P<0.01)2.2Subjective assessment:The total improvement rate of five dimensions in QSQ such as daytime sleepiness symptoms(76.2%vs25.6%)and signs during the day (71.4%vs10.2%) and night (54.8%vs5.1%), emotion (54.8%vs2.5%) and ability of social intercourse (50.0%vs2.5%) and the total score (57.1%vs7.7%) in the treatment group were higher than control group, Postoperative moderate to severe indexes in ESS decreased to23.8%in the treatment group,that were lower than51.3%in control group. The treatment group was significantly better than the control in quality of life postoperatively.ConclusionLow-temperature plasma-assisted H-UPPP combined with lymphoidectomy in radix linguae and CCT is effective in the patients with severe OSAHS, and it also can improve the quality of life postoperatively.