The Intra-oral Measurement Of OSAHS In Pre & Post-operation And The Observation Of Relative Indexes With HGB And Others

Objective1. We used the self - designed intra - oral measure appliances to collect the Obstructive Sleep Apnea - hypopnea Syndrome patients" data in pre&post -operation, in order to define Obstructive position and resected range, and evaluate the efficiency of operation.2. Before and after U - vulopalatopharyngoplasty, we observed Red blood cell, Hemoglobin and Hematocrit in OSAHS patients, and studied whether they could be used to evaluate the state of OSAHS.Material and method1. The measurements of each patient included: length of softpalate, distance of pharynx, distance of palatopharynx and length of uvula in pre & post -operation a month. These data were analyzed statistically.2. We recorded and analyzed these experiment data by means of statistical software of EXCEL.3. A set of self - designed intra - oral measure appliances.Results1. Palatopharykgeal data of normal and OSAHS group were as followed; distance of pharynx and distance of palatopharynx were significantly different ex-cept for length of softpalate and length of uvula (independent t - test, P <0. 01). The data of OSAHS group was significantly different in pre & post - operation ( paired - sample t - test P < 0.01).2. Red blood cell (RBC), Hemoglobin (HGB) , and Hematocrit (HCT) were significantly different in OSAHS group (40cases) in pre & post - operation a month ( paired - sample t - test P < 0.01).3. Result of follow up 6 months (40cases) : during three days post - operation, 17 patients of 27 underwent UPPP said to be pain of pharynx apparently (63.0% ). 6cases of 13 underwent H - UPPP said to be so (46. 2% ). There were 14 cases of temporary reflux of nasopharynx, and disappeared after 6 months. 11 cases of tracheotomy were extubated after 5 to 7 days, 3 cases of 11 said to be scream voice inspiration, and disappeared after 6 months. Improvement of snoring was 65% , total effective ratio of daytime sleep was 52.5% , and apnea was 65%. Pharynx dry was 32 cases, 1 case said to change sense of taste.Discussion1. For the operational curing of OSAHS patients, there is so much academic dispute in keeping the uvulo or not. The scholars who insist on doing classical UPPP operation or reform UPPP all believe that only confirm the location of the obstructive before operation, and only the obstructive of palatopharyngeal, we can get the best operation effects. In this group research, there are 27 cases undergone UPPP (67.5 percent) , 13 cases undergone H - UPPP (32.5 percent) among 40 cases. Our conclusion is that we should not much emphasize on a special operative method. For the patients who have much long uvulo, we should cut one third of it. It not only expands his throat space, but also keeps the shape post - operation. It also solved the problem that so many patients worry about without " little tongue" . Distance of pharynx and distance of palatopharynx were significantly different except for length of softpalate and length of uvula. The results were in accordance with Boot H 's etc. reports, and not with relative interior periodicals completely, it needed to be studied deeply. We studied and foundthat the difference of three indexes of RBC, HGB and HCT for the OSAHS patients after and before operation in one month have statistic magnificent significance. But the difference of MCV indexes have not statistic significance . It is different with the RBC, HCT,MCV,MCHC of the guide of OSAHS (draft) reported by the relative journals in 2002.2. If we make pre - operation intra - oral measurement to OSAHS patients and obstructive conform position with intro - oral measurement appliance designed by ourselves,it is not only economic but also convenient. And if we combine with the indexes of pre - operation RBC HGB HCT and ESS, we tried to choose OSAHS patients. The efficiency rate of this group study object is 52. 5% , it is higher than reported by external Woodson and others, there are 50% ; lower than Ikesas 70% , and Elasfours 72%. The reasons of the patients who have little charge compare with pre - operation syndrome sometimes with little chin, tongue hyper - trophy and nasal obstructive. We have not solved above problems when we operated UPPP. So it is much complicate in diagnosis and treatment for the patients of OSAHS. We should organize the co - operation with multi - department, include behavior science, vascular physical science, neurology and oral surgical science, and then we can get the best treatment efficiency.3. In this group cases that we studied, AHI; low: 2 cases (5% ) ; moderate: 5 cases (12.5%); high; 33 cases (82.5%), LSa2: low: 3 cases (7. 5% ) ; moderate; 26 cases (65% ); high: 11 cases (27.5% ). This imply that the OSAHS patients lack of the correct recognition to this disease, So the time of diagnosis and treatment are too late. The problems either exist in the patients, or in some medical staff lack of the correct recognition to the prevalence and severity of this disease. So it is necessary to propagate the dangerous factor and harmfulness of OSAHS, and we should try to discover, diagnose and treat early.Conclusion1. We made use of self - designed intra - oral measurement appliance to define the position of obstruction and accurate resected range in OSAHS patient,...