多层螺旋CT评估减重配合H-UPPP手术对于OSAHS患者颈部各间隙脂肪体积变化的影响  

The Effection of the Clearance Volume Fat in Neck to Patients after H-UPPP Surgery and Weight Loss by MSCT

作　　者：车子刚[1] 何双八[2] 张庆宇[1] 葛洪[1] 储成凤[1] 嵇洪波 于振坤[2] 孟玮[2] 

机构地区：[1]东南大学医学院附属南京同仁医院影像科,江苏南京211102 [2]东南大学医学院附属南京同仁医院耳鼻咽喉-头颈外科,江苏南京211102

出　　处：《中国CT和MRI杂志》2017年第11期60-62,共3页Chinese Journal of CT and MRI

基　　金：江苏省卫生厅医学科研项目(编号:H201444)

摘　　要：目的探讨OSAHS患者进行H-UPPP手术同时配合减重有效治疗后上气道各间隙脂肪含量的变化。方法选取2009年1月-2014年12月我院就诊重度OSAHS患者20例,行H-UPPP术+3月有效减重有效治疗的OSAHS患者,对其有效治疗前后分别行多导睡眠呼吸监测、颈部多层螺旋CT(MSCT)扫描及随机软件后处理重建,分析鼻咽脂肪体积(NPFV),口咽脂肪体积(OPFV),喉咽脂肪体积(LPFV),颈部皮下脂肪体积(NSFV),舌体组织体积(TBTV)的变化。结果OSAHS患者治疗前后NPFV、LPFV值差异无统计学意义;OPFV、NSFV值差异有统计学意义;治疗前后TBTV值差异有统计学意义。结论 1.OPFV、NSFV值治疗前后有明显变化,考虑体积增加直接导致咽喉部软组织增多,引起上气道狭窄,呼吸阻力增高,进而加重OSAHS。2.NPFV、LPFV值治疗前后差异无统计学意义,考虑该区域脂肪增多,但无可以增加患OSAHS的风险的直接证据。3.TBTV值有明显变化,考虑3月H-UPPP手术+有效减重治疗对于舌体体积有明显影响。MSCT可对H-UPPP术+3月有效减重有效治疗的OSAHS患者治疗前后的颈部脂肪体积变化作客观评价,有较高的临床应用价值。Objective To OSAHS patients with effective H - UPPP surgery and weight loss at the same time, studing the change of fat in each airway clearance on content were.Methods Selected 20 severe OSAHS patients beween 200901 to 201412 in our hospital, of the effective treatment is HUPPP ＋ 3 months effective weight loss to patients, Before and after effective treatment, patients need PSG, guide and neck MSCT scanning, analysis of nasopharynx fat volutue（NPFV）/oropharynx fat volume（OPFV）/ laryngealpharynx fat volutue（LPFV）/neck subcutaneous fat volutue（NSFV）and tongue body tissue volutue（TBSV） changes.ResultsFor OSAHS patients, more effective weight ＋ H - march UPPP surgery before and after treatment, two groups of Statistical data, NPFV and LPFV were not statistically sigmficant difference volume percentage of fat , and no obviously changed before and after the treatment; OPFVand NSFV were statistically significant difference volume percentage of fat, and had obviously changed; There was statistically significant difference before and after treatmentof TBSV, and had obviously changed before and after treatment.Conclusion1.Before and after treatment, Statistical data of OPFV and NSFV had obviously changed, therefore, consider the fat gap increase lead to throat soft tissue increased, caused airway stenosis, respiratory resistance increased, aggravated OSAHS.2. Statistical data of NPFV and LPFV were rich, That had not obviously changed before and after treatment, so considered its regional fat increased no evidence ,it could increase the risk of OSAHS. 3 Before and after HUPPP ＋ 3 mondas effective weight loss. Statistical data of TBTV had obviously changed, eonsided the treatment had significant effect to the tongue body volume. MSCT could do objective evaluation for neck fat volume changes of OSAHS patients with HUPPP ＋ 3 months effective weight loss ,and has certain clinical application.

关 键 词：减重 OSAHS HUPPP 脂肪分布 

分 类 号：R826.62[医药卫生—临床医学]