| Objective:To investigate the efficacy and influencing factors of H-UPPP combined with low-temperature tongue ablation surgical in adult OSAHS patients.Methods:41 patients were diagnosed as OSAHS which were moderate and severe by PSG at E.N.T department sleep monitoring center from January 2016 to October 2017.These patients were examed by electronic laryngoscope laryngoscopy and considered the obstruction site is mainly in oropharyngeal plane,and reufsed to take continuous positive airway pressure treatment,these patients showed strong willingness for surgical treatment.There were 41 patients treated with H-UPPP combined with low temperature plasma tongue and tongue base ablation in our department.All patients were treated by ventilator for 5-7 days before surgery.No serious complications were found after surgery.The average review time is six months.The observed indicators include:AHI,the lowest oxygen-saturation(LSaO2),blood oxygen saturation is lower than 90%of the time percentage of total sleep time(CT90),body mass index(BMI),Epworth sleep scale(ESS),total sleep time,rapid eye movement(REM)sleep period time and the percentage of total sleep time.The statistical applications processing SPSS 17.0 software were used for analysis.Pearson correlation analysis was used for the two qualitative data correlation,P<0.05 was considered statistically significant.Results:41 patients preoperative and postoperative parameters were compared.Grouped according to the diagnostic criteria of the Chinese Medical Association Otolaryngology Head and Neck Surgery Branch in 2009,the results were:6 cases were cured,19 cases were markedly effective,11 cases were effective,and 5 cases were ineffective,the total effective rate was 87.81%,the effective rate was 46.34%,the cure rate was 14.63%,and the invalid rate was 12.19%.The AHI、LSa02、CT90、ESS、REM difference was statistically significant(P<0.05).The BMI,TST difference was not statistically significant(P>0.05).The successful rates of different Friedman classifications have difference,the type I successful rate was significantly higher than type III;different tonsil sizes and different tongue heights had different surgical efficacy.The patient’s weight,age,and gender have no effect on the surgical efficacy.The ESS was positively correlated with the severity of the patient’s condition,and was negatively correlated with the patient’s rapid eye movement.And the ESS was positively correlated with the patient’s condition,was negatively correlated with the deep sleep time.Conclusions:1.The efficacy of H-UPPP combined with tongue plasma ablation for OSAHS can achieved a positive effect.For those OSAHS patients who cannot tolerate or refused CPAP treatment or have oropharyngeal stenosis,surgery is an effective treatment.But the Friedman classification can affect the efficacy,in order to have a satisfied effects,should be fully evaluated before surgery;strictly grasp the standards of select patients.2、The AHI is an indicator of evaluating the patient’s condition,but not the only one,the degree of disorder sleep structure,LSaO2,ESS score,CT90 are also an important indicator to judge the severity of OSAHS.ESS in patients with negative correlation with REM/TST,positively correlated with AHI、CT90.There were differences in the improvement of AHI before and after operation of patients with different Friedman classification.we can through the surgical procedure that increase REM sleep time,reduces oxygen deprivation time and improve the sleep quality,then improve the daytime sleepiness. |
