| ObjectiveTO evaluate the efficacy of uvulopalatopharyngoplasty(UPPP) combined with low-temperature plasma radiofrequency ablation to inferior turbinate in the treatment of severe obstructive sleep apnea hypopnea syndrome (OSAHS), efficacy and joint surgery clinical basis.MethodsConfirmed by clinical examination and sleeping through the night monitoring patients with severe OSAHS, and these clinical and imaging and other examinations to consider blocking parts of the order the velopharyngeal narrow flat and simple, turbinate hypertrophy in patients with OSAHS100cases were randomly dividedturbinate ablation the UPPP joint for the two groups, experimental group and control group was simply UPPP surgery group, after six months follow-up and review PSG ESS and other objective and subjective efficacy evaluation and statistical analysis. All patients in the routine preoperative continuous positive airway pressure (Continuous Positive Airway Pressure CPAP) treatment of5-7d, fill in the ESS sleep score and supervised the Epworth sleepiness scale (ESS) scale, the experimental group, all patients had concomitant UPPP United inferior turbinate radiofrequency ablation surgery, the inferior turbinate radiofrequency ablation technique using U.S. Arthrocare company ENTec-Coblator Ⅱ low temperature such as ion radio frequency treatment instrument and supporting RF heads, the control group as simple UPPP surgery group, after the end of surgery to enter the ICU monitoring and treatment of12～～24h application of antibiotics and hemostatic2d, intravenous hydrocortisone100～150mg/d, treatment2～3d, parallel to the pharynx aerosol inhalation. After oxymetazoline piece of cotton convergence of the nasal cavity.The statistical processing applications SPSS13.0software package for analysis, measurement data (x±s) said, the comparison of the t test, and count data using χ2test, P<0.05was considered statistically significant.Results1. Postoperative reactions and complications:patients with operative time of60～ 120min, operative hemorrhage volume <50ml in all cases after surgery was well tolerated after24-48h local pain and swelling,2patients had transient nasalerosion, not bleeding, suffocation and other serious complications. Clinical review after6months follow-up, the experimental group patients were snoring, apnea and daytime sleepiness and other symptoms were relieved or disappeared, nasal obstruction improved. Control group except for no change in nasal obstruction, other symptoms improved to varying degrees.2.6months after clinical and PSG, ESS score review and evaluation standards developed under the2009Chinese Medical Association of Otolaryngology Head and Neck Surgery Branch of efficacy. In this study, the total effective rate of the experimental group was78.0%; Total effective rate of the control group was56.0%. The experimental group and control group compared to the efficiency difference was statistically significant (P<0.05); The apnea hypopnea index (AHI). lowest oxygen saturation (LSaO2), ESS score index difference was statistically significant (P<0.01), BMI, the difference was not statistically significant (P>0.05).Conclusions1. Experimental group after a UPPP joint inferior turbinate radiofrequency ablation, the clinical symptoms improved significantly after six months PSG review, the total efficiency, the ESS score compared with control group difference was statistically significant. We believe that the severe OSAHS accompanied by inferior turbinate hypertrophy in patients with simple line UPPP surgery efficacy is not good, need to join under the turbinate radiofrequency ablation.2. UPPP combined with inferior turbinate low temperature radiofrequency ablation in patients with severe OSAHS, conventional surgery or staging operation compared to the treatment program, both to avoid the pain of patients with surgical staging brought, but also to reduce the economic burden, under the premise of guaranteeing the safety ofreceived a satisfactory effect. |
