单纯鼾症患者鼾声来源特点的初步研究  

The preliminary study of the origin characters of snore in simple snorers

作　　者：许辉杰[1] 于晖[2] 贾瑞芳[2] 高瞻[1] 黄魏宁[1] 彭好[1] 

机构地区：[1]北京医院耳鼻咽喉科,北京100730 [2]北京医院麻醉科

出　　处：《临床耳鼻咽喉头颈外科杂志》2015年第11期977-979,983,共4页Journal of Clinical Otorhinolaryngology Head And Neck Surgery

基　　金：国家自然科学基金(No:61271410)

摘　　要：目的:研究单纯鼾症患者鼾声来源的特点,为其治疗提供依据。方法:经多导睡眠监测诊断为单纯鼾症的患者共32例,用异丙酚复合右美托米啶进行诱导睡眠后,通过纤维鼻咽喉镜观察不同患者仰卧位打鼾时咽部组织振动的部位、方式及相伴随的塌陷情况。结果:32例患者中,14例表现为咽部单一结构振动,其中单纯软腭振动者13例,单纯会厌振动者1例。18例表现为咽部2种或2种以上结构振动,其中软腭+会厌振动者6例,软腭+会厌+舌根振动者2例、软腭+咽侧壁振动者5例、软腭+咽侧壁+会厌+舌根振动者5例。软腭和咽侧壁振动的幅度大,多伴随着明显的塌陷;会厌及舌根多振动轻微,伴随塌陷情况的患者较少。结论:单纯鼾症患者的鼾声以单独或主要来源于软腭振动者为多见,其次来源于软腭加咽侧壁共同振动,其他来源者罕见。咽部组织塌陷部位与咽部主要的振动部位基本一致。Objective：To investigate the origin characters of snore in simple snorers and provide the basis for its treatment. Method：Thirty-two simple snorers diagnosed by polysomnography were induced to sleep by propofol and dexmedetomidine, then we observed the vibration sites, pattern and concomitant collapse of soft tissue in pha-ryngeal cavity by nasendoscopy. Result： Thirteen cases showed palatal fluttering only, and 1 case showed vibration of epiglottis only. Six cases showed palatal fluttering with vibration of epiglottis, and 2 cases showed palatal flut-tering with vibration of epiglottis and tongue base. Five cases showed palatal fluttering with vibration of pharyngeal lateral wall, and 5 cases showed palatal fluttering with vibration of lateral wall, epiglottis and tongue base together. Palate and pharyngeal lateral wall vibrated strongly and always collapsed with vibrating, but epiglottis and tongue base usually vibrated slightly and seldom collapsed. Conclusion：The palatal fluttering is the main source of snoring sounds for most simple snorers, then followed by vibration of palatal and pharyngeal lateral wall together. The site of collapse in pharyngeal cavity is consistent with the main site of vibration.

关 键 词：打鼾 药物诱导下睡眠内镜检查法 睡眠呼吸暂停低通气综合征 阻塞性 

分 类 号：R563.8[医药卫生—呼吸系统]