本文選題：上氣道 + 腺樣體肥大　； 參考：《昆明醫(yī)科大學》2017年碩士論文

【摘要】：[目的]本課題以50名具有明顯顱頜面畸形伴腺樣體肥大并處于發(fā)育高峰前期或高峰期的患兒作為研究對象,采用X線頭顱側(cè)位片、電子鼻咽喉鏡、便攜式多導睡眠監(jiān)測儀,觀測該類患兒顱頜面、氣道形態(tài)特征;通過對患兒呼吸功能的分析,研究電子鼻咽鏡和X線頭顱側(cè)位片對腺樣體肥大判別的差異性;探究三種檢查手段診斷腺樣體肥大對顱面形態(tài)及呼吸功能影響的方法,為多學科聯(lián)合診斷、治療錯鄈畸形伴腺樣體肥大患兒提供有效的治療途徑。[方法]以具有明顯顱頜面畸形伴腺樣體肥大并處于發(fā)育高峰前期或高峰期的患兒作為研究對象。對患兒的年齡、性別、體重、睡眠呼吸狀態(tài)等信息進行分析。通過臨床檢查對患兒的牙弓寬度、腭蓋高度等信息進行分析。分別采用X線頭顱側(cè)位片(A/N值)和電子鼻咽鏡對腺樣體肥大進行判別,根據(jù)兩者的差異將50名患兒分為兩組:T1組(腺樣體占后鼻孔范圍50%); T2組(腺樣體占后鼻孔范圍20%)。對38項指標進行測量后,采用SPSS22.0統(tǒng)計學軟件對顱頜面、上氣道各測量數(shù)據(jù)進行分析,比較兩組顱頜面、氣道測量指標和呼吸功能是否存在差異。[結(jié)果]1、研究患兒50例,男28例,女22例:年齡8～13歲,不同患兒具有不同的錯鄈畸形表現(xiàn),以骨性Ⅱ類31人(占62%)居多、骨性Ⅰ類12人(占38%)、骨性Ⅲ類7人(占]4%);高角(MP-FH30.5°) 40人、均角(23.5°≤MP-FH≤30.5°) 8 人、低角(MP-FH23.5°) 2 人。患兒臨床表現(xiàn):長窄面型有38人;牙弓狹窄、腭蓋高拱有39人;鼻孔較小28人;睡眠打鼾25人;夜間張口呼吸34人;無家族遺傳史37人。2、根據(jù)昆明醫(yī)科大學附屬醫(yī)院耳鼻喉科鼻咽鏡檢查報告將患兒分組:T1 (腺樣體占后鼻孔范圍50%)、T2 (腺樣體占后鼻孔范圍≥50%),通過比較兩組患兒顱頜面、氣道測量值,除PNS-ad2差異有明顯統(tǒng)計學意義(P0.01)外,其他測量值均無統(tǒng)計學意義。3、50名患兒均通過便攜式睡眠檢測儀檢查,結(jié)果顯示:T1組中18人均存在呼吸功能異常,以低通氣(OHI5有27人,占94.7%)為主,僅有1人呼吸功能正常(AHI=0,占5.2%); T2組中29人存在呼吸功能異常,其中有2人(占6.4%)診斷為兒童OSAHS,有2人呼吸功能正常(AHI=0,占6.4%)。[結(jié)論]1、處在生長發(fā)育期的青少年,因腺樣體肥大造成上呼吸道阻塞引發(fā)口呼吸,將對其顱頜面和上氣道形態(tài)產(chǎn)生影響,其中以II類高角骨面型居多。2、X線頭顱側(cè)位片、電子鼻咽鏡和便攜式睡眠檢測儀是評價兒童腺樣體肥大和呼吸功能異常的常用手段,但臨床中X線頭顱側(cè)位片和電子鼻咽鏡對腺樣體肥大診斷存在差異。3、本研究采用便攜式PSG對患兒呼吸功能進行分析,為錯鄈畸形伴腺樣體肥大患兒的有效診治提供科學依據(jù)。
[Abstract]:[objective] in this study, 50 children with craniomaxillofacial malformation with adenoid hypertrophy and in the prepeak or peak period of development were studied, and lateral radiographs, electronic nose and throat endoscopy, and portable polysomnography were used.The morphological characteristics of craniomaxillofacial and airway were observed, and the difference between electronic nasopharyngoscope and X-ray lateral radiographs on adenoid hypertrophy was studied by analyzing the respiratory function of the children.To explore three methods to diagnose the effect of adenoid hypertrophy on craniofacial morphology and respiratory function, and to provide an effective treatment approach for children with malformation and adenoid hypertrophy.[methods] Children with craniomaxillofacial malformation and adenoid hypertrophy were studied.The age, sex, body weight and sleep breathing status of the children were analyzed.The width of dental arch and height of palatal lid were analyzed by clinical examination.Adenoid hypertrophy was judged by X ray lateral cephalograms (A / N) and electronic nasopharyngoscope. According to the difference, 50 children were divided into two groups: group T 1 (adenoid occupied the area of posterior nostril, 50%) and group T2 (adenoid, area of posterior nostril, 20%).After 38 items were measured, the data of craniomaxillofacial and upper airway were analyzed by SPSS22.0 software, and the difference of airway measurement index and respiratory function between the two groups was compared.[results] 1. There were 50 children (28 males and 22 females) in the study, aged 813 years. Different children had different malformation. Most of them were bone type 鈪，

本文編號：1762512