Further Evaluation of Uvulopalatopharyngoplasty in the Treatment of Obstructive Sleep Apnea Syndrome
Further Evaluation of Uvulopalatopharyngoplasty in the Treatment of Obstructive Sleep Apnea Syndrome
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悬雍垂腭咽成形术治疗阻塞性睡眠呼吸暂停综合征的进一步评价
DOI：
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发表时间：
1985
期刊：
影响因子：
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通讯作者：
W. Friedman
中科院分区：
文献类型：
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作者：
G. Katsantonis;J. Walsh;P. Schweitzer;W. Friedman
悬雍垂腭咽成形术（UPPP）自1981年引入以来，已成为治疗阻塞性睡眠呼吸暂停（OSA）的永久性气管切开术的替代手术方法。然而，选择该程序候选人的标准尚不清楚，阳性反应的预测仍然是一个谜。本文介绍了35例中重度阻塞性睡眠呼吸暂停患者的UPPPs经验。患者选择标准包括呼吸暂停严重程度、心肺后遗症和临床病理学。除两名患者外，所有患者均表现出临床改善，尽管反应程度存在相当大的差异。根据严重程度指数（SI）将患者分为良好或不良反应者，SI代表每小时睡眠中导致氧饱和度低于85%的呼吸暂停和呼吸不足的数量。SI改善大于50%被认为是良好缓解。23例患者（65.7%）为良好反应者，其余12例（34.3%）为不良反应者。在32例出现日间嗜睡或严重心肺后遗症的患者中，16例无需永久性气管造口术。因此，UPPP似乎可用于治疗大多数OSA患者。
Since its introduction in 1981 uvulopalatopharyngoplasty (UPPP) has become an alternative surgical approach to permanent tracheostomy in treating obstructive sleep apnea (OSA). However, the criteria for selecting candidates for this procedure are unclear and the prediction of a positive response remains an enigma. This article presents the experience with UPPPs performed on 35 patients who had moderate to severe OSA. Criteria for patient selection included apnea severity, cardiopulmonary sequelae, and clinical symptomatology. All but two patients demonstrated clinical improvement, although there was considerable variability in the degree of response. Patients were classified as good or poor responders on the basis of the severity index (SI), which represents the number of apneas and hypopneas per hour of sleep resulting in oxygen saturation below 85%. A greater than 50% improvement in the SI was considered a good response. Twenty-three patients (65.7%) were good responders and the remaining 12 (34.3%) were poor responders. The need for permanent tracheostomy was obviated In 16 of 32 patients presenting with disabling daytime sleepiness or severe cardiopulmonary sequelae. Therefore it appears that UPPP is useful for treating most OSA patients.