非内视镜下Müller呼吸检测上气道顺应性  

Evaluation of upper airway resilience under Müller respiration by non-endoscopic method

作　　者：唐世雄[1] 王耀文[1] 江远明[1] 姚寿国[1] 卿菁[1] 张旭群[1] 叶贤旺[2] 潘宇宁[2] 

机构地区：[1]宁波市第一医院耳鼻咽喉科,浙江宁波315010 [2]宁波市第一医院影像科

出　　处：《临床耳鼻咽喉头颈外科杂志》2012年第18期779-782,共4页Journal of Clinical Otorhinolaryngology Head And Neck Surgery

摘　　要：目的:应用320排CT与Müller呼吸检测上气道顺应性,探讨OSAHS患者高顺应性平面的非侵入、客观检测方法及意义。方法:经PSG确诊的OSAHS患者50例(OSAHS组)和无打鼾的咽异感症者10例(对照组),采用320排CT分别于平静呼气时与Müller呼吸时扫描各组咽喉部气道,获得腭后区、舌后区的最小矢径、最小横径、最小截面积,计算各壁的顺应性,并分析咽壁总顺应性、BMI、AHI的相关性。采用常规纤维内镜下Müller试验,比较2种检测方法的差异;采用SPSS 13.0软件包进行统计分析。结果:OSAHS组咽壁顺应性大于对照组;腭后区咽壁顺应性大于舌后区咽壁顺应性;腭后区咽侧壁顺应性大于前后壁顺应性;BMI、AHI、咽壁总顺应性之间呈正相关,但AHI与咽壁顺应性之间非线性相关,有些轻度OSAHS者之咽壁顺应性高于中、重度者,部分中、重度者咽壁顺应性反而较低。不同程度OSAHS患者咽壁顺应性与传统Müller试验气道塌陷的百分比成正比。结论:非内视镜下Müller呼吸320排CT检测上气道顺应性,是一种简捷、客观检测OSAHS高顺应性平面的方法,有助于OSAHS的临床诊断、病因研究及治疗方案的制订。为减少辐射剂量,在临床应用时只在Müller吸气相扫描1次上气道,结合咽喉视察即可确定OSAHS患者上气道高顺应性塌陷平面或解剖狭窄平面。Objective：To evaluate diagnostic significance of the noninvasive and objective 320-slice CT scan in the high pharynx resilience in the patients with obstructive sleep apnea/hypopnea syndrome. Method： Fifty patients with OSAHS and 10 patients with pharyngeal paraesthesia were included in the study. 320 slice CT scan was used to measure the sagittal diameters, transverse diameters and sectional area of the retropalatal region, retr0glossal region. Calculating the pharynx wall resilience. Analyzing the correlativity of pharynx wall resilience, BMI and AHI. Fiber endoscope was used to assess the subsidence percentage of the pharynx wall. Result.. Between OSAHS patients and pharyngeal paraesthesia patients, there was obviously difference in the retropalatal region and retroglossal region upper airway. The pharynx wall resiliences of retropalatal region were much more than that of retroglossal region. The later pharynx wall resiliences were much more than the fore-to-aft pharynx wall resilienees in the retropalatal region. BMI, AHI and the pharynx wall resilience were positive correlative to each other. But AHI and the pharynx wall resilience was nonlinear correlative. There was a good concordance between the pharynx wall resilience detected by 320CT and subsidence percentage of the pharynx wall detected by fiber endoscope. Conclusion： 320 slice CT is a kind of simple, rapid and objective method to localize the high resilience area of upper respiratory tract, which can be benefit to the clinical diagnosis, the etilogical study and the treatment of OSAHS. Based on physical examination, we propose that only one time of CT scan to the patients upper airway at the stage is enough to localize the stenosis area, which can reduce radiation dosage dramatically.

关 键 词：睡眠呼吸暂停低通气综合征 阻塞性 咽壁顺应性 体层摄影术 X线计算机 纤维内镜 Müller呼吸 

分 类 号：R563.8[医药卫生—呼吸系统]