头颅X线测量在阻塞性睡眠呼吸暂停综合征诊治中的意义  

The value of cephalometric analysis in diagnosis and treatment of obstructive sleep apnea syndrome

作　　者：柳端今[1] 杜兴亚[1] 林宇华[1] 赵燕玲[1] 杨庆文[1] 胡海宏 

机构地区：[1]北京同仁医院耳鼻咽喉-头颈外科

出　　处：《中华耳鼻咽喉科杂志》1998年第1期49-51,共3页Chinese Journal of Otorhinolaryngology

摘　　要：目的探讨头颅Ｘ线测量对阻塞性睡眠呼吸暂停综合征（ｏｂｓｔｒｕｃｔｉｖｅｓｌｅｅｐａｐｎｅａｓｙｎ－ｄｒｏｍｅ，ＯＳＡＳ）的诊断、治疗及评估预后的意义。方法对５０例连续无选择经ＭｅｄｉｌｏｇＳＡＣ（ｓｌｅｅｐａｎ－ａｌｙｚｉｎｇｃｏｍｐｕｔｅｒ）８４７诊断为ＯＳＡＳ患者及３０例无鼾症健康对照摄取头颅Ｘ线侧位片，并进行头颅Ｘ线测量。结果５０例患者平均呼吸紊乱指数（ＡＨＩ）为５１．４２±３．９６，全部行激光辅助悬雍垂腭成型术（ｌａｓｅｒ－ａｓｓｉｓｔｅｄｕｖｕｌｏｐａｔｏｐｌａｓｔｙ，ＬＡＵＰＰ）术，术后４～８个月随诊２５例。以ＡＨＩ减少５０％或呼吸暂停指数（ＡＩ）少于２０次为成功，前者为１０／２５例（４０％）、后者为１５／２５例（６０％）。分别将对照组与术前、术后成功者、失败者的头影测量数据进行对比，统计学结果示，ＯＳＡＳ有下列解剖形态学的改变：①悬雍垂软腭组织增长增厚；②后鼻棘至舌根距离延长；③舌骨低位；④舌骨后移；⑤后气道间隙变小（腭咽平面）；⑥硬腭长；⑦下颌骨体后移位。结论Ｘ线头影测量可显示上气道阻塞平面位置、上气道、硬腭结构的解剖及病理形态改变。以上资料可供制定手术计划及预估悬雍垂腭咽成型术（ｕｖｕ－ｌ?Objectives To study the value of cephalometric analysis in the diagnosis、treatment option and evaluation of prognosis. Methods A detailed cephalometric analysis was performed using lateral X ray films from 50 cases with obstructive sleep apnea syndrome (OSAS) and 30 age and sex matched controls. Results Statistical results showed that OSAS patients were different from controls in the following aspects: ① Their uvula, soft palate and tongue were significantly enlarged. ② The hyoid bone was displaced inferiorly and posteriorly. ③the posterior airway space (palatopharyngeal plane) was narrow. ④ The hard palate was elongated. ⑤ The mandibular body was retropositioned. Fifty unselected consecutive OSAS patients( mean AHI 51.42±3.96, Medilog SAC 847, Oxford UK) underwent LAUPP using CO 2 laser. Twenty five cases were followed up for 4 8months. 10/25 had obtained a reduction in AHI>50%、15/25 had AI<20 times. The success rate was compared with cephalomentric findings. Conclusion Cephalometry has an important diagnostic and predictive value in the clinical investigation of patients suspected of having OSAS.

关 键 词：睡眠呼吸暂停 综合征 诊断 计算机辅助 测颅法 

分 类 号：R563.805[医药卫生—呼吸系统]