[Diagnose and treatment of severe obstructive sleep apnea hypopnea syndrome].

OBJECTIVE: To explore the diagnose and treatment of severe OSAHS with distinction of different extent. METHOD: All 256 severe OSAHS patients were divided into two groups according to sleep apnea hypopnea index (AHI): group one (severe group), 40 < AHI < 65; group two (extra severe group), AHI > or = 65. All patients were underwent CPAP treatment for at least one week before modified UPPP in general anesthesia. UPPP and (or) nasal septum plasty or partial inferior turbinectomy were operated in one stage if tracheotomy was conducted. If tracheotomy were not conducted, the patient was only accepted UPPP under general anesthesia. The other operations to remove the multi block factors were operated in local anesthesia. RESULT: In 198 group one patients, there were 169 patients accepted UPPP in general anesthesia without tracheotomy, the other 29 patients were conducted with tracheotomy. The tracheotomy rate was 14.6%. The total effective cure rate was 85.9%. In all 58 group two patients, tracheotomy were conducted, and the total effective cure rate was 63.8%. The complication rate of all the two groups' patients was 3.5%. After three weeks,the uvulas decurtated from(4.89 +/- 0.58) cm to (3.12 +/- 0.46)cm. CONCLUSION: It is important to divide the severe OSAHS patients into severe group and extra severe group because the treatments were different. Not all the severe OSAHS patients need tracheotomy. There were advantages to retain the uvula in UPPP and patients' life quality was improved with uvula reserved.