喉源性阻塞性睡眠呼吸暂停低通气综合征的临床观察  

Obstructive sleep apnea hypopena syndrome caused by laryngeal diseases

作　　者：李树华[1] 石洪金[1] 董卫东[1] 吴大海[1] 

机构地区：[1]沈阳军区总医院耳鼻咽喉科,沈阳110016

出　　处：《山东大学耳鼻喉眼学报》2012年第6期4-7,共4页Journal of Otolaryngology and Ophthalmology of Shandong University

基　　金：辽宁省科技攻关计划(2010225036)

摘　　要：目的探讨喉源性阻塞性睡眠呼吸暂停低通气综合征(OSAHS)的病因、临床表现和治疗特点。方法回顾分析13例经治疗喉原发病使OSAHS获得有效治疗而确诊为喉源性OSAHS的病例,总结分析其病因、临床表现和治疗特点。结果造成喉源性OSAHS发病原因包括双侧声带麻痹、喉乳头状瘤、会厌肿瘤、会厌软化等,主要由声门和会厌病变引起喉内呼吸道狭窄所致;此类患者多不肥胖,声门病变导致OSAHS者多数存在轻度呼吸困难,经治疗喉原发病,OSAHS获得了很好疗效。结论喉腔疾病可以导致喉源性OSAHS的发生,临床上喉源性OSAHS并非罕见,治疗喉原发病可以使喉源性OSAHS得到有效治疗。Objective To analyze the correlation of neck circumference （NC） with sleeping-respiratory parameters and dimensions of upper airway in the patients with obstructive sleep apnea hypopnea syndrome （OSAHS）. Methods 61 OSAHS patients diagnosed by polysomnogaphy （PSG） were included in this study. With CT scanning, the velopharyngeal and glossopharyngeal cross-sectional area, dimensions of upper airway and the area ratio of pharynx/ neck were measured. NC, body mass index （BMI）, height and weight were collected. The correlation between NC and the other parameters were analyzed. Results In 61 OSAHS patients, NC was positively correlated with BMI （ r =0. 623, P 〈0.01 ）, and positively correlated with T90 and ODI, respectively （ r =0. 284, P 〈0. 05 ; r =0. 260, P 〈 0.05 ）. NC was negatively correlated with LSaO2 （ r = - 0.317, P 〈 0.05 ）, as well as two area ratios of pharynx/neck （ r = - 0. 258, P 〈 0. 05 ; r = - 0. 276, P 〈 0.05 ）. Finally, NC was positively correlated with the front diameter of velopharyngeal region and the back diameter of glossopharygeal region （ r = 0. 293, P 〈 0. 05 ; r = 0. 290, P 〈 0.05）. Conclusion The increasing NC can scale down the cross-sectional area of upper airway and aggravate airway obstruction, hypertrophy of soft palate, and hyoxemia. NC is a good predictor for the development of OSAHS.

关 键 词：睡眠呼吸暂停 阻塞性 体质量指数 颈围 氧减指数 气道梗阻 

分 类 号：R766.7[医药卫生—耳鼻咽喉科]