[Efficacy of Barbed reposition pharyngoplasty combined with Han-Uvulopalatopharyngoplasty for the treatment of OSAHS patients].

Objective: To study the efficacy of Barbed reposition pharyngoplasty (BRP) combined with Han-Uvulopalatopharyngoplasty (H-UPPP) in surgical treatment of OSAHS patients. Methods: OSAHS patients admitted to our department from June 2021 to February 2022 who met the surgical enrollment criteria were divided into two groups by surgical procedure: H-UPPP operation group [Control group, 47 cases, including 42 males and 5 females, aged 18-64 (37.77±11.65)years, and H-UPPP+BRP group [Study group, 48 cases, including 45 males and 3 females, aged 23-60 (39.10±9.86) years]. The surgical efficacy 6 months after operation was retrospectively analyzed. Meanwhile, the relationship between the surgical efficacy and modified Friedman pharyngeal anatomical stages was analyzed. The postoperative pain VAS score at first 3 days and the incidence of foreign body sensation in pharynx after 6 months of operation were compared between the two groups. Statistical analysis was conducted by SPSS 23.0. Results: There were no significant differences in gender, age, BMI, Friedman pharyngeal anatomical stages, ESS score, AHI and LSpO2 between the two groups, preoperatively (P>0.05). There was significant difference between the two groups in ratio of cumulative time of oxygen saturation below 90% to total sleep time(CT90), preoperatively. Surgical efficacy of H-UPPP operation group was 48.9% (23/47), while H-UPPP+BRP operation group was 70.8% (34/48), which was statistically significant (χ2=4.74, P=0.029). H-UPPP+BRP group seemed to have a higher surgical efficacy than H-UPPP group in patients with Friedman Ⅱb (87% vs. 61.9%) and Ⅲ stage (44.4% vs. 15%), but there was no statistically significant difference (P>0.05). H-UPPP+BRP group had a higher pain VAS score in first three days (t=-3.10, P=0.003), also had higher incidence of pharyngeal foreign body sensation after 6 months of operation (χ2=4.727, P=0.030). Conclusions: In the surgical treatment of OSAHS patients, the overall efficacy of BRP combined H-UPPP surgery is higher than that of H-UPPP surgery alone. It may be more suitable for OSAHS patients with modified Friedman type Ⅱb and type Ⅲ stage.目的： 研究倒刺线软腭咽侧悬吊咽成形术（Barbed reposition pharyngoplasty，BRP）联合改良悬雍垂腭咽成形术（Han-Uvulopalatopharyngoplasty，H-UPPP）治疗阻塞性睡眠呼吸暂停低通气综合征（OSAHS）患者外科手术疗效。 方法： 回顾性分析2021年6月—2022年2月入住武汉大学人民医院耳鼻咽喉头颈外科，符合研究入组标准的OSAHS外科手术患者资料。按照手术方式分成2组：单纯H-UPPP手术组［对照组，47例，其中男42例，女5例，年龄18~64（37.77±11.65）岁］和H-UPPP+BRP联合手术组［研究组，48例，其中男45例，女3例，年龄23~60（39.10±9.86）岁］。分析2组患者术后6个月手术有效率以及改良Friedman咽部解剖分型与2组患者手术疗效的关系；比较2组患者术后3 d疼痛视觉模拟评分（visual analogue scale，VAS）以及术后6个月咽部异物感发生率。采用SPSS 23.0软件进行统计学分析。 结果： 2组患者术前性别、年龄、体质量指数（BMI）、Friedman分型及Epworth 嗜睡量表（Epworth Sleepiness Scale，ESS）评分、睡眠呼吸暂停低通气指数（AHI）、最低脉搏氧饱和度（lowest oxygen saturation，LSpO2）的差异均无统计学意义（P>0.05）。2组血氧饱和度低于90%累计时间占总睡眠时间比（ratio of cumulative time of oxygen saturation below 90% to total sleep time，CT90）比较差异有统计学意义（Z=2.29，P=0.022）。手术有效率方面，H-UPPP组为48.9%（23/47），H-UPPP+BRP组为70.8%（34/48），2组差异具有统计学意义（χ2=4.74，P=0.029），H-UPPP+BRP联合手术组较单纯H-UPPP手术组在Friedman 咽部解剖分型Ⅱb（87% vs. 61.9%）及Ⅲ型（44.4% vs. 15%）患者中似乎有更高的手术有效率，但差异无统计学意义（P>0.05）。与单纯H-UPPP手术组相比，H-UPPP+BRP组术后3 d疼痛VAS评分较高（t=-3.10，P=0.003），术后6个月咽部异物感发生率较高（χ2=4.73，P=0.030）。 结论： 在OSAHS患者外科手术治疗中，BRP联合H-UPPP手术整体有效率高于单独的H-UPPP手术，可能更适合于Friedman咽部解剖分型中Ⅱb和Ⅲ型患者。.