鼾症-颌下腺下垂与阻塞性睡眠呼吸暂停综合症  

Snoring-The submandibular gland droop and Obstructive Sleep Apnea Syndrome

作　　者：刘爱荣[1] 邓湖山[1] 陈世汉[1] 房民琴[1] 李康[1] 黄子斌[1] 李玉兰[1] 

机构地区：[1]三峡大学第一临床医学院宜昌市中心人民医院 耳鼻咽喉科,宜昌443003

出　　处：《重庆医科大学学报》2007年第5期528-530,共3页Journal of Chongqing Medical University

摘　　要：目的:研究阻塞性睡眠呼吸暂停综合症(OSAS)患者的颌下腺及其与阻塞性睡眠呼吸暂停综合症的关系;研究摘除颌下腺治疗OSAS。方法:随机对确诊为OSAS的患者20例,对颌下腺进行CT扫描和MR检查,术前行多导睡眠监测(PSG),以及颌下腺摘除术中对颌下腺形态和走向进行观察,并总结其症候群;其中8例自愿行术后PSG,对患者及家属进行调查和随访,以确定治疗效果。结果:20例OSAS患者均有颌下腺移位肿大,即向下移位和肿大;术后监测8例AHI均在14.90以下;12例患者阻塞性睡眠呼吸暂停(OSA)消失,8例呼吸暂停明显缓解;8例鼾声消除,12例减弱;全部患者白天疲劳消除,高血压患者舒张压降至90mmHg以下;随访12例患者12-24个月,无1例OSA复发。结论:鼾症可能引起颌下腺移位肿大,使舌根后坠和舌体高拱,同时压迫咽腔通道,最终导致OSAS;颌下腺移位肿大是OSAS的主要成因之一,摘除移位肿大的颌下腺是治愈OSAS的主要方法之一。Objective：To investigate the relationship between submandibular gland droop and Obstructive Sleep Apnea Syndrome （OSAS）. Methods：20 patients with established OSAS were randomly checked up through CT scanning and MR examining. PolySomnoGraphy （PSG）was performed before operation,and submandibular morphology was studied,symptoms sumed up,8 volunteering patients underwent PSG after operation.patients and their familymembers were investigated in the follow-up. Results： 20 patients with OSAS developed submandibular gland droop,including downwand displacement and swelling.AHI was monitored to be below 14.90 in 8 cases pastoperatively;OSA disappeared in 12 patients and notable relief of OSA Occurred in 8 patients; snoring was eliminated in 8 patients,lowered in 12 patients;daytime fatigue disappeared in all patients,and diastolic pressure decreased to lower than 90mmHg in hypertensive patients.No recurrence was found in the 12-24 months of follow up.Conclusions： submandibular gland droop is a complication of snoring,submandibular gland droop and swelling let the base of tongue fall back,and the body of tongue run up.Submandibular gland droop is the most significant cause for OSAS.Removal of drooping submandibular gland is an effective cure for OSAS.

关 键 词：阻塞性睡眠呼吸暂停综合症 颌下腺移位肿大 颌下腺摘除 

分 类 号：R766.7[医药卫生—耳鼻咽喉科]