上气道CT多呼吸时相OSAS阻塞部位定位效果  

Location effect of upper airway obstruction with OSAS multi-slice spiral CT in sleep and awake state

作　　者：陈鹏[1] 崔红领[1] 胡海英[1] 林运智[1] 崔庆周[1] CHEN Peng;CUI Hong-Ling;HU Hai-Ying(Department of Radiology,Luohe City Central Hospital,Henan 462000,China)

机构地区：[1]漯河市中心医院,河南462000

出　　处：《放射学实践》2020年第6期720-724,共5页Radiologic Practice

摘　　要：目的:观察多呼吸时相(睡眠与清醒状态时)阻塞性睡眠呼吸暂停综合征(OSAS)患者的上气道CT阻塞部位的定位效果。方法:对2018年1~10月间本院就诊的74例OSAS患者进行清醒状态(吸气末)和睡眠状态(打鼾、血氧饱和度下降、呼吸暂停同时发生时)的上气道阻塞部位定位扫描,分析清醒和睡眠两种状态下的上气道阻塞部位定位结果、矢状面横截面积、矢状面气道最小直径、睡眠与清醒状态转换时的最狭窄部位变化情况。结果:上气道部位(软腭后区气道、悬雍垂后区气道、舌后区气道和会厌后区气道)阻塞诊断率比较,睡眠状态(75.67%、28.38%、59.46%、24.32%)均显著高于清醒状态(45.94%、8.11%、36.49%、4.05%)(P<0.05);软腭后区气道和舌后区气道的矢状面横截面积、矢状面气道最小直径比较,OSAS患者睡眠状态的测量值明显小于清醒状态;睡眠与清醒状态转换时,软腭后区气道闭塞者和舌后气道闭塞者的最狭窄部位基本一致,但当患者处于睡眠状态时的狭窄程度或闭塞范围增大。结论:与清醒状态时比较,药物诱导睡眠状态下行CT上气道阻塞部位定位效果明显较优,睡眠状态下可真实再现OSAS患者上气道阻塞部位,对OSAS临床诊治具有较高指导意义。Objective:To observe the localization effect of upper airway CT obstruction site in patients with obstructive sleep apnea syndrome(OSAS)in multiple breathing phase(sleep and awake state).Methods:Seventy-four OSAS patients were scanned for the location of upper airway obstruction in waking and sleeping states.The results of location of upper airway obstruction in multi-breathing phase,sagittal cross-sectional area,sagittal airway minimum diameter,and the change of the narrowest part during the transition from sleep to waking state were analyzed.Results:The diagnostic rates of upper airway obstruction(posterior soft palate airway,posterior uvula airway,posterior lingual airway and posterior epiglottic airway)were significantly higher in sleep(75.67%,28.38%,59.46%,24.32%)than in awake(45.94%,8.11%,36.49%,4.05%)(all P<0.05);Compared with the sagittal cross-sectional area and the sagittal minimum diameter of the posterior soft palate airway and the posterior lingual airway,the sleep status of OSAS patients was significantly lower than that of awake patients.The narrowest part of the airway occlusion in the posterior soft palate area was basically the same as that in the posterior tongue area when the sleep and waking state were changed,but the degree or extent of the airway occlusion increased when the patients were in the sleep state.Conclusions:Compared with awake state,the location effect of CT upper airway obstruction in drug-induced sleep state is obviously better.Sleep state can truly reproduce the upper airway obstruction in OSAS patients,which has a higher guiding significance for the clinical diagnosis and treatment of OSAS.

关 键 词：睡眠呼吸暂停 阻塞性 气道阻塞 体层摄影术 X线计算机 患者定位 

分 类 号：R814.4[医药卫生—影像医学与核医学] R749.79[医药卫生—放射医学]