咽声反射在阻塞性睡眠呼吸暂停低通气综合征患者临床诊断及手术疗效评价中的应用  

Application of acoustic pharyngealmetry to the diagnosis and surgical effect evaluation of patients with OSAHS

作　　者：杨晓彬[1] 严小玲[1] 翟锦明[1] 欧阳顺林[2] 陈观贵[1] 廖礼兵[1] 田慎之[1] 黄映红[1] 毛敏[1] 马钊恩[1] 王晓利[1] 宗凌[1] 张建国[1] 

机构地区：[1]广州医科大学附属第二医院耳鼻咽喉科,广东广州510260 [2]广州医科大学附属第三医院耳鼻咽喉科,广东广州510150

出　　处：《中国耳鼻咽喉颅底外科杂志》2015年第5期368-373,共6页Chinese Journal of Otorhinolaryngology-skull Base Surgery

基　　金：广东省自然科学基金(S2013010014907)

摘　　要：目的探究利用咽声反射测试对临床上可疑阻塞性睡眠呼吸暂停低通气综合征(OSAHS)患者进行初步筛选,并评价OSAHS患者的手术疗效。方法 50例健康成年人为体检健康组;57例临床上有睡眠打鼾症状的患者为实验组,其中重度OSAHS患者行腭咽成形术(UPPP);利用咽声反射仪测量体检健康组和实验组的口咽结合处面积、会厌游离缘面积及距离、声门处的面积及距离、咽腔容积、咽腔长度、咽腔平均横截面积,且对重度OSAHS患者术前、术后1周、术后1个月的各指标进行监测,将检测结果进行统计学分析。结果 OSAHS组的体重、BMI、颈围均大于体检健康组,差异具有统计学意义(P<0.05),42例中重度OSAHS患者的口咽结合处面积、咽腔容积、咽腔平均横截面积均低于体检健康组,差异具有统计学意义(P<0.05),而会厌游离缘距离与体检健康组相比,差异无统计学意义(P>0.05)。25例重度OSAHS术后1周的口咽结合处面积、咽腔容积、咽腔平均横截面积大于术前(P<0.05),且术后1月的口咽结合处面积、咽腔容积、咽腔平均横截面积大于术后1周(P<0.05)。结论咽声反射检查技术可以对OSAHS进行初步的筛查,并能客观地评价重度阻塞性OSAHS患者的手术疗效。Objective To investigate the application of acoustic pharyngealmetry to preliminary screening of patients with suspected obstructive sleep apnea hypopnea syndrom（ OSAHS） and assessment of surgical effect of uvulopalatopharyngoplasty（ UPPP）. Methods 50 healthy adults were chosen as control. 57 patients with suspected OSAHS due to snoring and sleep apnea were included in the experimental group（ OSAHS group）. Of them,those with severe OSAHS underwent UPPP. The parameters such as area and distance of oropharyngeal junction,epiglottis free edge and the glottis,volume and length of pharyngeal cavity,average cross-sectional area of pharyngeal cavity in both groups were measured with acoustic pharyngealmetry. These parameters of patients undergoing UPPP were collected before operation,and one week,one month after operation separately. Results Body weight,BMI and neck circumference of OSAHS group were greater than those of the control group,the differences were statistically significant（ all P〈0. 05）.Area of oropharyngeal junction,volume of pharyngeal cavity,average cross-sectional area of pharynx cavity of 42 patients with moderate and severe OSAHS were lower than those of the control group,and the differences were statistically significant（ all P〈0. 05）,while the difference of distance of epiglottis free edge was statistically insignificant（ P〉0. 05）. Area of oropharyngeal junction,volume and average cross-sectional area of pharyngeal cavity of 25 patients with severe OSAHS one week after UPPP were greater than those obtained before operation（ all P〈0. 05）,and these parameters obtained at one month after UPPP were greater than those obtained at one week after operation（ all P〈0. 05）.Conclusion Acoustic pharyngealmetry can be used for accurate preliminary screening of OSAHS and assessment of surgical effect of UPPP on patients with severe OSAHS.

关 键 词：咽声反射 睡眠呼吸暂停 阻塞性 外科手术 

分 类 号：R766.4[医药卫生—耳鼻咽喉科]