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1、懸雍垂腭咽成形術(shù)患者應(yīng)用ApneaGraph的臨床分析1天津市醫(yī)科大學(xué)300070；2天津市人民醫(yī)院耳鼻咽喉頭頸外科300121【摘要】目的對阻塞平面為腭咽部的OSAHS患者UPPP手術(shù)前后ApneaGraph的結(jié)果進(jìn)行分析，評估手術(shù)療效，為上氣道測壓技術(shù)的應(yīng)用提供客觀依據(jù)。方法選擇準(zhǔn)備進(jìn)行懸雍垂腭咽成形術(shù)的患者，術(shù)前先進(jìn)行腭咽平面壓力的測定并與睡眠呼吸監(jiān)測結(jié)合開展同步整夜監(jiān)測，術(shù)后6個(gè)月、1年再次進(jìn)行相同的監(jiān)測，對兩組數(shù)據(jù)進(jìn)行比較和統(tǒng)計(jì)學(xué)分析，對比分析觀察患者的食道壓力的變化及各項(xiàng)相關(guān)指標(biāo)，并同步比較患者的主、客觀療效。結(jié)果患者術(shù)后6個(gè)
2、月及1年復(fù)查AG及PSG,與術(shù)前各項(xiàng)指標(biāo)對比分析發(fā)現(xiàn)，發(fā)生呼吸暫停時(shí)最大平均食道壓力、低通氣最大平均食道壓力、呼吸事件時(shí)最大呼吸努力、呼吸努力次數(shù)、AHI及最低血氧均得到明顯改善。術(shù)前、術(shù)后差異均有統(tǒng)計(jì)學(xué)意義(p<0.01)o結(jié)論ApneaGraph適用于臨床，具備了便攜PSG的功能，能夠協(xié)助定位診斷OSAHS患者的阻塞部位，對手術(shù)適應(yīng)癥的選擇具有重要的指導(dǎo)意義?！娟P(guān)鍵詞】懸雍垂腭咽成形術(shù)；睡眠呼吸暫停；阻塞性；壓力測定[Abstract】ObjectiveInviewoftheblockingplaneforpalatophary
3、ngealministryofOSAHSpatientsbeforeandafterUPPPsurgeryApneaGraphcomparingwiththeresultsofesophagealpressureanalysis,evaluationofsurgicalcurativeeffect,provideobjectivebasisoftheapplicationoftheAGtechnology.MethodsChoosepatientsthatreadytoUPPPsurgery,onpreoperativeApneaGrap
4、handPolysomnographyoverthecorrespondingperiod,,andtheAGandPSGwereappliedtocomparetwogroupsofdataandstatisticalanalusis6monthand1yearlatertocontrastanalysisoftheobservationinpatientswithesophagealpressurechangeandtherelatedindicators,andsynchronizationofthepatient'ssubject
5、iveandobjectivecurativeeffect.Results6monthsand1yearpostoperativelyinpatientswithreviewrespectiveofAGandPSG,comparedwiththepreoperativedata,themaximumaverageesophagealapneaoccurslowpressure,themaximumaverageesophagealpressureventilation,respiratoryeventsbestbreathing,brea
6、thinghaxdtimes,AHIandLSaO2%wereobviouslyimproved.Preoperativeandpostoperativedifferenceswerestatisticallysignificant(p<0.01).ConclusionApneaGraphisapplicabletoclinicahandhavethefunctionoftheportablePSG」tcanhelpblockingpartsofthelocalizationdiagnosisofOSAHS,andhasmporta
7、ntguidingsignificancetotheselectionofsurgicalcandidates?[Keywords]Uvulapalatepharyngoplasty；Sleepapnea；Obstructive；Pressuremeasurement阻塞性唾眠呼吸暫停低通氣綜合征(obstructivesleepapneahypopneasyndrome,OSAHS)是睡眠呼吸障礙性疾病中最有代表性的常見病、多發(fā)病，人群發(fā)病率為2%~4%[1],是指睡眠時(shí)上氣道塌陷阻塞引起呼吸暫停和低通氣。通常伴有打鼾、唾眠結(jié)構(gòu)紊亂、頻
8、繁岀現(xiàn)血氧飽和度下降，進(jìn)而出現(xiàn)白天困倦、注意力不集中等癥狀，并可能誘發(fā)高血壓、冠心病、代謝性疾病等多器官多系統(tǒng)損害[2]。目前公認(rèn)的三大致病因素為上氣道解剖結(jié)構(gòu)異常導(dǎo)致的上氣道阻塞、上氣道擴(kuò)張
