Müller状态下64排螺旋CT对阻塞性睡眠呼吸暂停低通气综合征诊断价值的研究  

The study of the diagnostic value of 64-slice CT in obstructive sleep apnea hypopnea syndrome in Müller mameuver

作　　者：周旭[1] 王建中[1] 刘骏桢[2] 

机构地区：[1]复旦大学附属中山医院耳鼻咽喉科,上海200032 [2]复旦大学附属中山医院放射科

出　　处：《临床耳鼻咽喉头颈外科杂志》2013年第3期139-143,共5页Journal of Clinical Otorhinolaryngology Head And Neck Surgery

基　　金：上海市卫生局科研基金资助(No:2008162)

摘　　要：目的:通过对平静呼吸和Müller状态下的中重度OSAHS患者行CT扫描,了解Müller状态下上气道阻塞塌陷的具体部位、程度及累及范围,为手术治疗提供依据。方法:对30例经PSG确诊的中重度OSAHS患者分别行平静呼吸和Müller状态下64排VCT扫描,并经上气道三维重建和仿真内镜技术处理,比较2种状态下上气道各平面横截面积和各径线长度以及咽壁厚度、软腭悬雍垂长厚度、软硬腭角度、舌骨硬腭距离等指标。结果:平静呼吸时吸气末和Müller′s动作吸气末各平面截面积和径线比较,舌根后区及会厌后区的前后径差异无统计学意义(P>0.05),其余所有气道径线的差异均有统计学意义(P<0.05)。各平面软组织厚度比较,软腭后区、悬雍垂后区、舌根后区左右侧壁软组织厚度及软腭后区的后壁厚度、悬雍垂软腭长厚度比较差异均有统计学意义(P<0.05),软硬腭角度比较差异有统计学意义(P<0.05),舌骨的位置在Müller′s动作时有显著的下移。结论:通过64排CT上气道三维重建和仿真内镜技术,可推测中重度OSAHS患者打鼾时上气道塌陷阻塞的具体部位、程度、累及范围,以及上气道各平面软组织的变化情况,其临床应用价值大。Objective.. To examine the location,extent and cause of collapsed airway in Mtiller maneuver in OS- AHS patients with CT scan,and provide the evidence for surgery. Method：Thirty patients with moderate or severe OSAHS were measured with 64 slice CT in quiet breathing and in M^iller maneuver. After three-dimensional re- construction and virtual endoscope handing of the upper airway, we compare the cross-section area and the dimen- sions Of five levels as well as the thickness of retropharyngeal and lateral pharyngeal tissue in two conditions. The evaluation values include the length and thickness of soft palate and uvula, soft-hard palate angle and hyoid hard palate distance. Result：The lateral distance , anterior - posterior distance , cross - sectional area , but AP of RG andEPG region, were statistically different in quiet breathing and in Mailer maneuver. The thickness of retropharyn- geal and lateral pharyngeal tissue were statistically different in two conditions, and the length and thickness of soft plate and uvula, soft-hard angle and hyoid hard palate distance were statistically different. Conclusion： Three-di- mensional reconstruction and virtual endoscope of 64 slice CT can clearly show the location,extent and cause of occlusion of the upper airway, which helps well clinical application.

关 键 词：睡眠呼吸暂停低通气综合征 阻塞性 上气道 体层摄影术 X线计算机 

分 类 号：R563.8[医药卫生—呼吸系统]