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題名 | 雷射懸雍垂侸咽整型術=Laser Assisted Uvulopalatoplasty |
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作者 | 蔡添祥; 鄭良信; Tsai, Tien-hsiang; Cheng, Stephen Liang-hsin; |
期刊 | 中華民國耳鼻喉科醫學會雜誌 |
出版日期 | 19980400 |
卷期 | 33:2 1998.04[民87.04] |
頁次 | 頁28-33 |
分類號 | 416.87 |
語文 | chi |
關鍵詞 | 阻塞型呼吸中止症候群; 雷射懸雍垂侸咽整型術; 懸雍垂侸咽整型術; 人體肥胖度指數; Obstructive sleep apnea syndrome; Laser-assisted uvulopalatoplasty; Uvulopalatopharyngoplasty; Body mass index; |
中文摘要 | 背景:過去對於打鼾和阻塞性睡眠呼吸中止症候群(OSAS)的治療大部分採用 咽 整型手術[uvulopalatopharyngoplasty (UPPP)],不過自從數年前雷射懸雍垂 咽整型術 [laser-assisted uvulopalatoplasty (LAUP)]方法被引進國內,LAUP遂提供另一可行的治療 方法。本研究目的是在探討影響LAUP術後的可能因子,長、短期術後成功率及併發症。 方法:本研究從1994年3月至1996年3月,2年間共收集192例病例,施行210次LAUP 手術,分別在術後半年及一年半作電話訪問或門診追蹤記錄。手術方法係採用二氧化碳雷射 汽化軟 和懸雍垂。統計係採單變數分析(one-way ANOVA)之Scheffe's test。 結果:LAUP術後半年,追蹤調查結果發現:成功率高達87%(相當程度打鼾改善者占 61%+部份改善者占25%),而無明顯改善者只占13%。術後經過一年半追蹤結果成功率降 至70%(相當程度改善者占48%+部分改善者22%),無明顯改善增加到30%,另本研究發 現人體肥胖指數[body mass index(BMI)],在術後無明顯改善這組(BMI=27.9 kg/m )比 有明顯改善組(BMI=25.9 kg/ m )有較高的BMI值,統計呈負相關(r=-0.0889)但無顯 著差異(p=0.11)。肥胖的人(BMI>30 kg/ m )比理想體重者(BMI<25 kg/ m ),LAUP 術後具較差的預後。 結論:本研究顯示LAUP術後成功率隨時間拉長而下降,BMI是LAUP預後的重要因 子。數據也顯示病人併有鼻或扁桃腺病變時順便作鼻手術或扁桃腺切除對打鼾治癒成功率有 益。(中耳醫誌 1998; 33;126-131。) |
英文摘要 | Background: In the past snoring and obstructive sleep apnea were treated with uvulopharyngoplasty but within the last few years, laser-assisted uvulopalatoplasty (LAUP) became widespread as alternative treatment method. Method: At our hospital from March 1994 to march 1996, we performed 192 cases (210 procedures) with CO laser evaporation of soft palate and uvula. Result: Short 6 month follow up success rate was 87% ( good response 61%+partial response 26%) and no response of 13%. Long 18 month follow-up success rate was 70% (good response 48% + partial response 22% and no response of 30%). In addition, no response had a BMI (body mass index) of 27.9 kg/ m , and good response had a BMI of 25.9 kg/ m , therefore poor response had a higher BMI. Conclusion: The success rate for obese patients (BMI >30 kg/ m ) versus ideal body weight patient (BMI<25 kg/ m ) was poorer. In conclusion the success rate of LAUP drops with longer follow-up. |
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