电子鼻咽镜在Ⅱ型OSAHS患者上气道测量中的应用  

Application of electronic nasopharyngoscope in upper airway measurement of patients with type Ⅱ OSAHS

作　　者：薛章委[1] 廖智萍[1] XUE Zhangwei;LIAO Zhiping(Department of Otolaryngology,Affiliated Hospital of Putian University of Fujian Medical University,Putian 351100,China)

机构地区：[1]福建医科大学莆田学院附属医院耳鼻咽喉科,福建莆田351100

出　　处：《中国现代医生》2022年第14期120-124,共5页China Modern Doctor

基　　金：福建省莆田市科技局科研基金项目(2020S3F010)。

摘　　要：目的应用电子鼻咽镜测量Ⅱ型阻塞性睡眠呼吸暂停低通气综合征(OSAHS)患者上气道结构的变化,予指导改良悬雍垂腭咽成形术中软腭切除的范围,观察其手术疗效。方法选取2020年2~10月,福建医科大学莆田学院附属医院耳鼻咽喉科应用电子鼻咽镜,经鼻分别测量试验组38例Ⅱ型OSAHS患者与对照组38例健康成人腭部的长度及咽后壁派氏嵴的距离,分析两组所得参数;试验组采用完整保留软腭游离缘及悬雍垂改良术式,根据测量数据切除软腭组织,平均切除软腭长度(10.3±3.7)mm。术后随访6~12个月,观察术后并发症及临床疗效。结果两组测量所得咽后壁的派氏嵴距离比较,差异无统计学意义(P>0.05),腭部长度比较,差异有统计学意义(P<0.05),试验组患者明显变长,手术切除变长的软腭组织,术后随访其临床疗效比较,差异有统计学意义(P<0.05),两组均未出现术后常见的并发症。结论应用电子鼻咽镜可直视下评估OSAHS患者在清醒状态下的上气道解剖结构变化,为手术治疗OSAHS患者定量提供切除软腭的范围,提高手术疗效,有效防止术后并发症的发生。Objective To measure the changes of upper airway structure in patients with type Ⅱ obstructive sleep apnea hypopnea syndrome(OSAHS)with the electronic nasopharyngoscope,and to guide the improved range of soft palate resection in the improved uvula palatopharyngoplasty and to observe its therapeutic effect.Methods From February 2020 to October 2020,the electronic nasopharyngoscope was used in our department to measure the length of the palate and the distance of Passavant's ridge in the posterior pharyngeal wall of 38 patients with type Ⅱ OSAHS(the experimental group)and 38 healthy adults(the control group)via nose,and analyze the parameters of the two groups.The complete preservation of soft palate free edge and improved uvula palatopharyngoplasty were adopted in the experimental group,and the soft palate was removed based on the measurements,with mean resected length of soft palate of(10.3±3.7)mm.The postoperative complications and clinical efficacy were observed during the follow-up of 6-12 months.Results No statistically significant difference was observed in the distance of Passavant's ridge in the posterior pharyngeal wall between the two groups(P>0.05),and a statistically significant difference was observed in the length of palate between the two groups(P<0.05).The lengths of the palate in the experimental group were significantly longer,and the long soft palate tissues were surgically removed.The postoperative follow-up showed statistically significant clinical efficacy(P<0.05),and no common postoperative complications were observed.Conclusion The electronic nasopharyngoscope can be used to evaluate the anatomical changes of upper airway in OSAHS patients under the awake state under direct vision,so as to provide a quantitative range of soft palate resection for patients undergoing surgical treatment of OSAHS,improve surgical efficacy and effectively prevent postoperative complications.

关 键 词：睡眠呼吸暂停 电子鼻咽镜 派氏嵴 改良悬雍垂腭咽成形 

分 类 号：R766[医药卫生—耳鼻咽喉科]