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1、悬雍垂腭咽成形术患者应用ApneaGraph的临床分析1天津市医科大学300070；2天津市人民医院耳鼻咽喉头颈外科300121【摘要】目的对阻塞平面为腭咽部的OSAHS患者UPPP手术前后ApneaGraph的结果进行分析，评估手术疗效，为上气道测压技术的应用提供客观依据。方法选择准备进行悬雍垂腭咽成形术的患者，术前先进行腭咽平面压力的测定并与睡眠呼吸监测结合开展同步整夜监测，术后6个月、1年再次进行相同的监测，对两组数据进行比较和统计学分析，对比分析观察患者的食道压力的变化及各项相关指标，并同步比较患者的主、客观疗效。结果患者术后6个
2、月及1年复查AG及PSG,与术前各项指标对比分析发现，发生呼吸暂停时最大平均食道压力、低通气最大平均食道压力、呼吸事件时最大呼吸努力、呼吸努力次数、AHI及最低血氧均得到明显改善。术前、术后差异均有统计学意义(p<0.01)o结论ApneaGraph适用于临床，具备了便携PSG的功能，能够协助定位诊断OSAHS患者的阻塞部位，对手术适应症的选择具有重要的指导意义。【关键词】悬雍垂腭咽成形术；睡眠呼吸暂停；阻塞性；压力测定[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阻塞性唾眠呼吸暂停低通气综合征(obstructivesleepapneahypopneasyndrome,OSAHS)是睡眠呼吸障碍性疾病中最有代表性的常见病、多发病，人群发病率为2%~4%[1],是指睡眠时上气道塌陷阻塞引起呼吸暂停和低通气。通常伴有打鼾、唾眠结构紊乱、频
8、繁岀现血氧饱和度下降，进而出现白天困倦、注意力不集中等症状，并可能诱发高血压、冠心病、代谢性疾病等多器官多系统损害[2]。目前公认的三大致病因素为上气道解剖结构异常导致的上气道阻塞、上气道扩张
