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目的:对局麻下低温等离子射频治疗阻塞性睡眠呼吸暂停低通气综合征(OSAHS)的疗效进行观察,为该手术的选择提供理论依据。方法:选用低温等离子射频于局麻下分别对138例OSAHS患者进行腭咽成形术治疗,术后随访6个月和12个月。根据手术前后PSG监测结果,得出治疗有效率,并比较睡眠呼吸暂停低通气指数(AHI)及最低血氧饱和度(LSaO2)改善情况。结果:术后6个月、12个月总有效率分别为85.7%和79.7%,平均AHI分别降低56.2%(P<0.01)及50.5%(P<0.05),平均LSaO2分别升高15.5%(P<0.05)及14.0%(P<0.05)。术后12个月与6个月比较,疗效差异无统计学意义,P>0.05。所有病例无术后呼吸道梗阻、无大出血等严重并发症。结论:局麻下低温等离子射频治疗OSAHS疗效确切,手术安全。在病例选择合适时,用局麻下行低温等离子射频腭咽成形术方法可达到全麻下行UPPP手术效果,在病例选择合适时用局麻方法可达到全麻手术效果。该术式可以成为OSAHS患者手术治疗的选择之一。
Objective: To observe the curative effect of low temperature plasma radiofrequency ablation on obstructive sleep apnea-hypopnea syndrome (OSAHS) under local anesthesia and to provide a theoretical basis for the selection of this operation. Methods: 138 patients with OSAHS underwent local velopharyngeal angioplasty under low temperature plasma radiofrequency ablation under local anesthesia. The patients were followed up for 6 months and 12 months. According to PSG monitoring results before and after surgery, the treatment efficiency was obtained, and the improvement of sleep apnea hypopnea index (AHI) and the lowest oxygen saturation (LSaO2) were compared. Results: The total effective rates at 6 months and 12 months after operation were 85.7% and 79.7% respectively. The mean AHI decreased 56.2% (P <0.01) and 50.5% (P <0.05) respectively, and the average LSaO2 increased 15.5% P <0.05) and 14.0% (P <0.05). After 12 months and 6 months, the difference was not statistically significant (P> 0.05). All cases without postoperative respiratory tract obstruction, no major complications such as bleeding. Conclusion: Local anesthesia with low temperature plasma radiofrequency treatment of OSAHS is effective and safe. In the case of the right choice, the use of local anesthesia with low temperature plasma 频 velopharyngeal angioplasty method can achieve the effect of UPPP anesthesia down surgery in the case of appropriate choice of local anesthesia can achieve the effect of general anesthesia. The procedure can be one of OSAHS surgical options.