阻塞性睡眠呼吸中止症的外科治療

Surgical Treatment for Obstructive Sleep Apnea

林政輝(Cheng-Hui Lin)

《台灣醫學》 18卷2期 (2014/03) Pp. 209-220

https://doi.org/10.6320/FJM.2014.18(2).11

摘要

目前，阻塞性睡眠呼吸中止症的治療以正壓呼吸器為第一線治療選擇。然而，患者接受度與長期配合度仍待提升。在必須獲得有效治療的需求之下，手術治療成為必須考慮的治療選擇之一。手術前評估包括患者基本資料、頭顱顏面以及上呼吸道檢查、鼻咽內視鏡、以及醫療影像檢查。最重要的，要有完整的夜間多項睡眠生理檢查，以確實了解患者睡眠呼吸狀況。常見的手術選項可以走上呼吸道軟組織手術，包含鼻呼吸道及咽呼吸道手術、顎面骨骼手術、氣管切開術、以及減重手術等等。睡眠呼吸中止症的手術，需要配合完整評估、有系統的分析才能選擇正確的治療方式。而手術中必須審慎操作並保留原有的上呼吸道生理功能。如此，才能為患者提供安全有效且傷害最小的手術治療。

關鍵字

睡眠呼吸中止症 ； 手術

並列摘要

Currently, positive airway pressure (PAP) remains the first-line treatment for adult patients with obstructive sleep apnea (OSA). However, the acceptance and long-term compliance to PAP therapy still needs to be optimized. With the needs of a feasible treatment, surgery has become one of the necessary options in the management of OSA. Pre-surgical evaluation comprises demographic data, craniofacial and upper airway examination, nasopharyngoscopy, and medical images. Above all, a full-montage over-night polysomnography can illuminate the respiratory events of the patient. Common surgeries for OSA include those for upper airway soft tissue (nasal or pharyngeal), maxillofacial skeleton, tracheostomy, and bariatric surgery. A surgery with proper combination and plan can only be composed through complete evaluation, examination, and systemic analysis. During the procedure, meticulous execution is mandatory to achieve the surgical goal without compromising the physiology in upper airway. And a harmless and effective surgery could be accomplished.

並列關鍵字

obstructive sleep apnea ； surgery

參考文獻

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