咽后壁瓣修复术后并发阻塞性睡眠呼吸暂停的临床研究

doi:10.7518/hxkq.2021.05.011

华西口腔医学杂志 ›› 2021, Vol. 39 ›› Issue (5): 566-569.doi: 10.7518/hxkq.2021.05.011

咽后壁瓣修复术后并发阻塞性睡眠呼吸暂停的临床研究

赵宁¹(), 刘振国², 许尧祥¹^,³, 岳金¹^,³, 薛令法¹^,³, 肖文林¹^,³()

^1.青岛大学口腔医学院，青岛 266555
^2.青岛大学附属医院西海岸院区耳鼻喉头颈外科，青岛 266555
^3.青岛大学附属医院西海岸院区口腔科，青岛 266555

收稿日期:2020-11-29 修回日期:2021-07-06 出版日期:2021-10-01 发布日期:2021-10-11
通讯作者: 肖文林 E-mail:1505738130@qq.com;wenlinxiao@sina.com
作者简介:赵宁，硕士，E-mail：1505738130@qq.com
基金资助:
山东省自然科学基金面上项目资助(ZR2015HM022)

Clinical study on obstructive sleep apnea following pharyngeal flap surgery

Zhao Ning¹(), Liu Zhenguo², Xu Yaoxiang¹^,³, Yue Jin¹^,³, Xue Lingfa¹^,³, Xiao Wenlin¹^,³()

^1.School of of Stomatology, Qingdao University, Qingdao 266555, China
^2.Dept. of Otolaryngology, Head and Neck Surgery, West Coast Hospital, the Affiliated Hospital of Qingdao University, Qingdao 266555, China
^3.Dept. of Stomatology, West Coast Hospital, the Affiliated Hospital of Qingdao University, Qingdao 266555, China

Received:2020-11-29 Revised:2021-07-06 Online:2021-10-01 Published:2021-10-11
Contact: Xiao Wenlin E-mail:1505738130@qq.com;wenlinxiao@sina.com
Supported by:
Natural Science Foundation of Shandong Province(ZR2015HM022);Correspondence: Xiao Wenlin, E-mail: wenlinxiao@sina.com

摘要/Abstract

摘要： 目的

探讨腭裂术后腭咽闭合不全（VPI）患者行咽后壁瓣修复术（PFS）后阻塞性睡眠呼吸暂停（OSA）的发生率及严重程度，并探讨手术年龄对OSA发生率及严重程度的影响。

方法

对82例接受PFS手术的腭裂患者进行回顾性研究，根据患者手术时的年龄分为两组，通过夜间多导睡眠监测（PSG）评估术后至少1.2年（平均6.0年）OSA的发生率及严重程度。

结果

成人组和儿童组术后OSA的发生率分别为20%和31%，两组间差异无统计学意义（P=0.289）。根据呼吸暂停低通气指数（AHI），将成人组及儿童组测得的OSA患者分为不同的严重程度（轻度、中度、重度），两组间OSA严重程度的差异无统计学意义（P=0.079）。

结论

本研究表明，腭裂患者行PFS平均术后6.0年，一部分患者依然患有OSA。基于本研究的数据表明，手术年龄对于术后远期OSA的发生率及严重程度无影响。

关键词: 阻塞性睡眠呼吸暂停, 腭裂, 多导睡眠监测, 腭咽闭合不全, 咽后壁瓣修复术

Abstract: Objective

This study aims to investigate the incidence and severity of obstructive sleep apnea (OSA) in cleft patients with velopharyngeal insufficiency (VPI) after pharyngeal flap surgery (PFS) and explore the influence of operation age.

Methods

A retrospective study was conducted in 82 cleft patients after PFS. The patients were divided into two groups according to their age at the time of surgery. The incidence and severity of OSA were assessed at least 1.2 years (mean 6.0 years) postoperatively by polysomnography (PSG).

Results

The incidence rates of OSA were 20% in the adult group and 31% in the child group. No significant difference was found between the two groups (P=0.289). Patients with OSA in the adult and child groups were classified into different levels of severity (mild, moderate, severe) according to the apnea hypoventilation index (AHI). No statistically significant difference in the severity of OSA was found between the two groups (P=0.079).

Conclusion

Some patients still have OSA average of 6.0 years after PFS, and operation ageis unrelated to the incidence and severity of OSA.

Key words: obstructive sleep apnea, cleft palate, polysomnography, velopharyngeal insufficiency, pharyngeal flap surgery

中图分类号:

R 782.2⁺2

赵宁, 刘振国, 许尧祥, 岳金, 薛令法, 肖文林. 咽后壁瓣修复术后并发阻塞性睡眠呼吸暂停的临床研究[J]. 华西口腔医学杂志, 2021, 39(5): 566-569.

Zhao Ning, Liu Zhenguo, Xu Yaoxiang, Yue Jin, Xue Lingfa, Xiao Wenlin. Clinical study on obstructive sleep apnea following pharyngeal flap surgery[J]. West China Journal of Stomatology, 2021, 39(5): 566-569.

图/表 2

参考文献 18

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项目		成人组	儿童组
患者人数/例	男	16	25
	女	14	27
腭裂裂型/例	双侧完全性腭裂	6	11
	单侧完全性腭裂	9	20
	不完全腭裂	15	21
腭裂修复手术术式/例	兰式法	8	5
	Furlow腭成形术	7	16
	两瓣法	5	18
	两瓣法+犁骨瓣法	-	10
	未知（外院手术）	10	3
咽后壁瓣手术年龄/年		23.3±4.2	8.9±4.1
随访时间/年		5.9±2.2	6.1±2.1

组别			n	AHI/h	LSaO₂/%
成人组（n=30）	正常		24	1.6±1.0	91±2
	轻度 OSA		6	9.7±2.8	88±3
	中度 OSA		0	-	-
	重度 OSA		0	-	-
儿童组（n=52）	正常	未成年	26	0.5±0.3	92±3
		已成年	10*	2.5±1.2	91±3
	轻度 OSA		10	2.6±0.9	90±4
	中度 OSA		6	7.8±1.3	88±4
	重度 OSA		0	-	-

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咽后壁瓣修复术后并发阻塞性睡眠呼吸暂停的临床研究

Clinical study on obstructive sleep apnea following pharyngeal flap surgery

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