河北医科大学学报 ›› 2024, Vol. 45 ›› Issue (7): 766-770.doi: 10.3969/j.issn.1007-3205.2024.07.005

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改良悬雍垂腭咽成形术对OSAHS患者睡眠及认知功能的影响

  

  1. 四川省雅安市人民医院耳鼻咽喉头颈外科，四川 雅安 625000

  • 出版日期:2024-07-25 发布日期:2024-07-18
  • 作者简介:程蕾蕾（1991-），女，四川雅安人，四川省雅安市人民医院主治医师，医学硕士，从事耳鼻咽喉头颈外科疾病诊治研究。
  • 基金资助:
    四川省医学（青年创新）科研课题项目（s20049）

Effects of modified uvulopalatopharyngoplasty on sleep and cognitive function in patients with OSAHS

  1. Department of Otolaryngology, Head and Neck Surgery, Ya′an People′s Hospital, Sichuan Province, Ya′an 625000, China

  • Online:2024-07-25 Published:2024-07-18

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摘要： 目的 探讨改良悬雍垂腭咽成形术（modified uvulopalatopharyngoplasty，H-UPPP）治疗阻塞性睡眠呼吸暂停低通气综合征（obstructive sleep apnea hypopnea syndrome，OSAHS）患者的效果，观察睡眠情况及认知功能的变化。
方法 将OSAHS患者118例纳入研究，依据不同治疗方法分为观察组与对照组，每组59例。对照组采用行为治疗，包括控制体重、戒烟戒酒、夜间侧卧等，观察组行H-UPPP治疗。治疗6个月后观察2组临床疗效，比较2组治疗前及治疗后6个月睡眠情况［呼吸暂停低通气指数（apnea hypopnea index，AHI）、最低血氧饱和度（lowest oxygen saturation，LSaO2）、鼾声指数（snore index，SI）、Ep-worth嗜睡量表（Ep-worth sleepiness scale，ESS）评分］和认知功能［Rey-Osterrieth复杂图形测试（complex figure test，CFT）评分、简易智能精神状态检查量表（mini-mental state examination，MMSE）评分、蒙特利尔认知评估表（Montreal cognitive assessment，MoCA）评分、事件相关电位P300］。
结果 观察组治疗效果优于对照组（P＜0.05）。治疗后6个月，观察组与对照组AHI、SI、ESS评分、P300潜伏期均低于治疗前，LSaO2、CFT、MMSE、MoCA评分、P300波幅高于治疗前（P＜0.05），且观察组AHI、SI、ESS评分、P300潜伏期低于对照组，LSaO2、CFT、MMSE、MoCA评分、P300波幅高于对照组（P＜0.05）。
结论 H-UPPP治疗OSAHS患者具有较好的效果，能够显著减轻临床症状，改善认知障碍程度，具有临床应用价值。


关键词: 阻塞性睡眠呼吸暂停, 改良悬雍垂腭咽成形术, 睡眠, 认知

Abstract: Objective To explore the effect of modified uvulopalatopharyngoplasty (H-UPPP) in the treatment of obstructive sleep apnea hypopnea syndrome (OSAHS), and to observe the changes of sleep and cognitive function. 
Methods A total of 118 patients with OSAHS were included in the study and divided into observation group (n=59) and control group (n=59) according to different treatment methods. The control group received behavioral treatment, including weight control, quitting smoking and drinking, keeping a lateral position during nighttime sleep, and the observation group received H-UPPP treatment. The clinical efficacy of the two groups was observed at 6 months after treatment, and the sleep conditions ［apnea hypopnea index (AHI), lowest oxygen saturation (LSaO2), snore index (SI), Ep-worth sleepiness scale (ESS) score］ and cognitive function ［Rey-Osterrieth complex figure test (CFT) score, mini-mental state examination (MMSE) score, Montreal cognitive assessment (MoCA) score, event-related potential P300］ of the two groups were compared before and at 6 months after treatment. 
Results The therapeutic effect of observation group was better than that of control group (P＜0.05). At 6 months after treatment, AHI, SI, ESS scores and P300 latency of observation group and control group were lower than those before treatment, while LSaO2, CFT, MMSE, MoCA scores and P300 amplitude were higher than those before treatment (P＜0.05). AHI, SI, ESS scores and P300 latency were lower in the observation group than in the control group, whereas LSaO2, CFT, MMSE, MoCA score and P300 amplitude of observation group were higher than those of control group (P＜0.05). 
Conclusion H-UPPP has a good effect in the treatment of OSAHS patients, which can significantly ameliorate clinical symptoms, improve the degree of cognitive impairment, and has application value in clincial practice.


Key words: obstructive sleep apnea, modified uvulopalatopharyngoplasty, sleep, cognition

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