内镜检查及上气道压力测定对阻塞性睡眠呼吸暂停低通气综合征患者上气道的评估价值  

Endoscopy with Müller's maneuver and airway pressure measurement method on the evaluation of the upper airway of obstructive sleep apnea hypopnea syndrome

作　　者：田旭[1] 霍红[1] 李五一[1] 王剑[1] 杨大海[1] 

机构地区：[1]中国医学科学院北京协和医学院北京协和医院耳鼻咽喉头颈外科,北京100730

出　　处：《山东大学耳鼻喉眼学报》2016年第5期29-32,共4页Journal of Otolaryngology and Ophthalmology of Shandong University

摘　　要：目的通过比较清醒时内镜检查及夜间上气道压力测定法在阻塞性睡眠呼吸暂停低通气综合征(OSAHS)患者术前上气道评估中的作用,探讨内镜检查对OSAHS上气道评估的临床价值。方法对OSAHS患者125例进行内镜检查判断上气道阻塞部位及塌陷方式,同期应用睡眠监测及上气道阻塞定位系统(AG)行整夜的睡眠监测上气道压力测定,对两种检查方法进行比较。结果内镜检查示,患者均有腭后区阻塞,舌后区阻塞74例,但塌陷方式不同;比较内镜检查的单纯腭后区阻塞组及腭后区、舌后区多平面阻塞组的AG测量值,下部阻塞低通气指数(AHI)及下部阻塞构成比的差异有统计学意义(P均<0.01)。结论内镜检查对于判断上气道阻塞部位及塌陷方式具有一定的临床价值,与AG相结合,指导手术方案的选择。Objective To compare daytime video-endoscopy with Muller＇s maneuver and nocturnal airway pressure measurement for upper airway （UA）assessment in patients with obstructive sleep apnea and hypopnea syndrome （OSAHS）,in order to explore the clinical value of daytime endoscopy in airway evaluation.Methods A total of 125 OSAHS cases were evaluated by daytime video-endoscopy with Muller＇s maneuver to determine the sites of obstruction and patterns of collapse.The cases also underwent nocturnal pressure measurements（ApneaGraph,AG）to identify obstruction sites.The results of the two methods were compared.Results Endoscopy with Muller＇s maneuver detected retropalatal obstruction in all cases,of which 74 had retroglossal obstruction,and the patterns of collapse were different. AG results showed that lower apnea hypopnea index （AHI）and the proportion of lower AHI were significantly higher in multilevel obstruction group than in isolated retropalatal obstruction group（all P 〈0.01）.Conclusion Daytime endos-copy with Muller＇s maneuver is of clinical value to evaluate the sites of obstruction and patterns of UA collapse.Com-bined with AG,it can help to guide the choice of surgical plan.

关 键 词：睡眠呼吸暂停 阻塞性 上气道 电视内镜 Müller手法 测压法 

分 类 号：R766.7[医药卫生—耳鼻咽喉科]