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目的:探讨诱导睡眠下电子喉镜在阻塞性睡眠呼吸暂停低通气综合征(OSAHS)定位诊断中的应用价值。方法:将经PSG确诊的132例OSAHS患者随机分成A、B2组:A组61例为实验组,术前给予咪唑安定诱导睡眠后用电子喉镜对上呼吸道进行动态观察,以确定阻塞部位;B组71例作为对照组,术前清醒状态下行常规上呼吸道检查和电子喉镜检查。所有患者均根据定位诊断结果进行针对性手术治疗。结果:A组存在多部位阻塞者达72.1%,而B组仅为33.8%,2组差异有统计学意义(P<0.05)。患者术后均随访6个月以上,A组总有效率达91.8%,B组仅为64.8%。A、B2组的治愈率、显效率、总有效率均差异有统计学意义(均P<0.05)。结论:诱导睡眠状态下大部分OSAHS患者上呼吸道存在多部位的解剖性狭窄,术前在诱导睡眠下应用电子喉镜进行OSAHS患者上呼吸道阻塞部位的定位诊断,并据此进行针对性的手术治疗,可以显著提高OSAHS手术治疗的效果。
Objective: To investigate the value of induction laryngoscope in the diagnosis of obstructive sleep apnea-hypopnea syndrome (OSAHS). Methods: A total of 132 OSAHS patients diagnosed by PSG were randomly divided into A and B2 groups. Group A (61 cases) was treated with midazolam preoperatively and the upper respiratory tract was observed with electronic laryngoscope before operation to determine the obstructive site. Group B, 71 cases as a control group, under normal preoperative awake state routine upper respiratory tract examination and electronic laryngoscopy. All patients according to the positioning diagnosis of targeted surgical treatment. Results: There were 72.1% patients in group A with multiple sites of obstruction, while those in group B were only 33.8%. There was significant difference between two groups (P <0.05). Patients were followed up for 6 months or more, the total effective rate was 91.8% in group A, only 64.8% in group B. The cure rate, effective rate and total effective rate in group A and B2 were all significantly different (all P <0.05). Conclusion: There are many anatomical stenoses in the upper respiratory tract of most patients with OSAHS during sleep-inducing sleep. The electronic laryngoscope is used to diagnose the location of upper airway obstruction in patients with OSAHS preoperatively and to conduct targeted surgical treatment , Can significantly improve the surgical treatment of OSAHS effect.