The Curative Effect Evaluation Of H-uvulopalatopgaryngoplasty In The Adults With Severe Obstructive Sleep Apnea Hypopnea Syndrome

Objective:To investigatethe curative effect evaluation of H-uvulopalatopgaryngoplasty in the adults with severe obstructive sleep apnea hypopnea.Methods:22 cases(aged from 22 to 54 years,mean 40.51±8.0 years)who diagnosed with severe OSAHS,underwent H-uvulopalatopgaryngoplasty,were included from E.N.T.department of Second Affiliated Hospital of Jilin University,dating from Jun 2015 to Jun 2016.The patients were followed up for six to eight months,who reviewed polysomnography(PSG),Epworth sleepiness scale(ESS)、Quebec sleep questionnaire(QSQ)and Electron-nasopharyngolarynscopy+Muller’s.We evaluate the efficacy of surgery through the PSG,ESS and QSQ before and after treatment.Results:1.Average AHI before and after surgery was 59.48±2.86 and26.74±2.79.The average LSa O2 value was 65.44±1.62 and 78.00±7.17.The average ESS value was 17.72±6.55 and 6.11±4.20.The average QSQ value was 3.34±1.42 and 5.98±0.45.The postoperative AHI 、LSa O2 、 ESS and QSQ were significantly improved(P < 0.01).In the followed-up patients,the total effective number was 17 patients,the total effective rate was 77.3%;without completely cured patients;14 patients were markedly effective,significant efficiency rate was 63.6%;threepatients effectively,effective rate was 13.6%.2.PSG indexes are not consistently associated with daytime sleepiness and OSAHS-related quality of life.Clinical outcomes should be evaluated with physiological and subjective measures.3.Patients who Muller’s tested with significant soft palate plane blocking,H-UPPP is effectively;With both soft palate and tongue plane blocking,H-UPPP is invalid or effectively but still belong to moderate to severe OSAHS patients postoperation.4.The operation effectiveness of this study is higher than the TCM scoring system predicting.There is no significant correlation between TCM score and the surgical vurative effect;In patients with tonsillar significantly larger,even if the TCM score > 22,surgery can be still valid.We can think that TCM scoring system can not be completely used to evaluate whether patients have operation indications.Conclusion1.After the subjective and objective examination,PSG,ESS and QSQ,the quantitative comparison of the preoperative and postoperative proved the H-uvulopalatopgaryngoplasty is effective on the treatment of the adults with severe obstructive sleep apnea hypopnea.But this surgery can only solve the oropharynx blocking or narrow,patients with severe OSAHS usually exist multiple plane blocking or narrow.Patients with invalid and poor curative effect should consider than there are other plane blocking or narrow and the second stage surgery may be necessary.2.PSG indexes are not consistently associated with daytime sleepiness and OSAHS-related quality of life.Clinical outcomes should be evaluated with physiological and subjective measures.3.Muller’s test,therefore,can more accurate assessment of patients withthe soft palate and tongue plane blocking and collapse.4.The operation effectiveness of this study is higher than the TCM scoring system predicting;There is no significant correlation between TCM score and the surgical curative effect;In patients with tonsillar significantly larger,even if the TCM score >20,the surgical curative effect can be still significantly higher than 10%.