目的 探讨阻塞性睡眠呼吸暂停 （obstructive sleep apnoea syndrome,OSAS）伴咽喉反流（laryngopharyngeal reflux,LPR）患者采用手术治疗的临床效果。方法 共计纳入OSA伴LPR患者56例,病例采集时间在2017年6月—2019年12月,所有患者均采用手术治疗,观察患者的治疗效果。结果 经统计56例患者术前临床症状中声嘶8.93%、清嗓10.71%、痰多或涕后流14.29%、吞咽困难7.14%、饭后躺下时咳嗽12.50%、呼吸困难或窒息发作8.93%、慢性咳嗽17.86%、咽异物感12.50%、反酸烧心7.14%;相关临床体征中假声带沟16.07%、喉室消失16.07%、喉水肿21.43%、红斑或充血17.86%、肉芽肿8.93%、后联合增生10.71%、声带水肿8.93%。手术后呼吸暂停低通气指数（apnea hypopnea index, AHI）水平低于手术前,血氧饱和度（oxygen saturation,简称SaO₂）水平高于手术前,患者治疗总有效率为92.86%;对比56例患者反流症状指数量表（reflux symptom index, RSI）显示手术后各项反流症状评分均低于手术前,对比差异显著（P<0.05）;而对比手术前后反流体征量表（reflux finding score, RFS）显示,患者手术前和手术后肉芽肿评分和后连合增生评分对比无明显差异（P>0.05）,但其余几项反流体征对比差异显著（P<0.05）。结论 对于OSAS伴LRP患者采用手术治疗方式可以有效缓解患者气道狭窄阻塞现象,改善患者的反流情况,临床应用效果显著。

Objective To discuss the effect of surgical treatment on obstructive sleep apnea syndrome （OSAS） patients with laryngopharyngeal reflux （LPR）. Methods A total of 56 OSAS patients with LPR were selected from June 2017 to December 2019. Surgical effects were reported. Results Among the 56 patients, the incidence rates of preoperative clinical symptoms such as hoarseness, hawking, excessive phlegm or running nose, dysphagia, cough upon lying down, breathing difficulty or asphyxia, chronic cough, foreign body sensation in throat, and sour regurgitation or heartburning were 8.93%, 10.71%, 14.29%, 7.14%, 12.5%, 8.93%, 17.86%, 12.5%, and 7.14%, respectively; the incidence rates of clinical signs like sulcus vocalis, disappeared ventriculus larynges, laryngeal edema, erythema or congestion, granuloma, posterior commissure proliferation, and vocal edema were 16.07%, 16.07%, 21.43%, 17.86%, 8.93%, 10.71%, and 8.93%, respectively. The apnea hypopnea index （AHI） after surgery was lower than before; the oxygen saturation （SaO₂） level was higher than before; the total effective rate was 92.86%. The reflux symptom index （RSI） item scores after surgery were lower than before （P<0.05）. The reflux finding score （RFS） results showed that except the granuloma and posterior commissure proliferation scores （P>0.05）, the remaining RFS item scores before and after surgery were significantly different （P<0.05）. Conclusion The surgical treatment for OSAS patients with LRP can efficiently relieve airway stenosis and choking, and improve reflux signs, showing a significant clinical effect.