【摘要】：阻塞性睡眠呼吸暫停綜合征(obstructive sleep apnea hypopnea syndrome,OSAHS)的發(fā)病主要是由于上氣道解剖上的狹窄和呼吸控制功能失調(diào)而造成。OSAHS癥狀正確診斷對于OSAHS的有效治療十分重要。上呼吸道CT對OSAHS患者上氣道狹窄部位掃描定位是臨床上的重要診斷手段,如何分析CT掃描數(shù)據(jù),對于正確判斷OSAHS具有意義。本研究以健康人群常規(guī)CT掃描數(shù)據(jù)確立了檢測指標的正常范圍,選用58例OSAHS患者進行上呼吸道CT。研究結(jié)果表明:58例患者中13例無明顯狹窄,45例患者存在橫截面狹窄,統(tǒng)計發(fā)現(xiàn)狹窄層面共71個。在45例OSAHS患者中,26例為單個層面狹窄,其中15例為軟腭后區(qū)狹窄,2例為懸雍垂區(qū)狹窄,4例為舌后區(qū)狹窄,5例為會厭后區(qū)狹窄;在45例OSAHS患者中,16例患者存在兩個層面的聯(lián)合狹窄,一般為相鄰部位,其中6例為軟腭后區(qū)+懸雍垂區(qū)狹窄;6例懸雍垂區(qū)+舌后區(qū)狹窄,4例為舌后區(qū)+會厭后區(qū)狹窄;另外,CT掃描顯示2例OSAHS患者的層面狹窄成3個部位的聯(lián)合,分別為軟腭后區(qū)+懸雍垂區(qū)+舌后區(qū);而2例患者的層面狹窄為4個部位聯(lián)合。進一步對15例清醒狀態(tài)和睡眠呼吸暫停狀態(tài)下的OSAHS患者進行的上呼吸道CT掃描對比發(fā)現(xiàn),清醒狀態(tài)下的上呼吸掃描提示的狹窄部位與睡眠呼吸暫停狀態(tài)下發(fā)生的阻塞部位基本吻合。從本研究結(jié)果,我們認為大多數(shù)OSAHS患者存在上呼吸道的解剖性狹窄,且狹窄部位基本與睡眠呼吸暫停發(fā)生狀態(tài)下阻塞部位相一致,進一步說明上呼吸道CT掃描對OSAHS患者阻塞及狹窄的定位具有重要臨床診斷價值。
[Abstract]:Obstructive sleep apnea syndrome (obstructive sleep apnea hypopnea syndrome,OSAHS) is mainly caused by anatomic stenosis of upper airway and maladjustment of respiratory control. The correct diagnosis of OSAHS symptoms is very important for the effective treatment of OSAHS. Upper respiratory tract CT is an important diagnostic method for upper airway stenosis in patients with OSAHS. How to analyze CT scan data is of significance to correctly judge OSAHS. In this study, the normal range of detection indexes was established by routine CT scan data of healthy population. 58 patients with OSAHS were selected for upper respiratory CT.. The results showed that 13 of 58 patients had no significant stenosis and 45 had cross-sectional stenosis. A total of 71 stenosed layers were found. Of the 45 patients with OSAHS, 26 were single level stenosis, including 15 cases of posterior soft palate stenosis, 2 cases of uvula stenosis, 4 cases of retrolingual stenosis and 5 cases of posterior epiglottic stenosis. Of the 45 patients with OSAHS, 16 had two levels of conjunctival stenosis, 6 of which were associated with the posterior soft palate uvula, 6 of the retrolingual and 4 of the posterior epiglottis, 6 of the 45 patients with OSAHS had conjunctive stricture, 6 of them were located in the posterior soft palate, 6 had the retrolingual stricture and 4 had the posterior epiglottis. In addition, CT scan showed that the laminar stenosis of 2 patients with OSAHS was combined into three parts, the posterior region of the soft palate was the posterior part of uvula and tongue, while the plane stenosis of 2 cases was combined with four sites. Further CT scans of upper respiratory tract were performed in 15 patients with OSAHS in awake state and sleep apnea. The stricture of upper respiratory scan in waking state coincided with that in sleep apnea. From the results of this study, we believe that most OSAHS patients have anatomic stenosis of the upper respiratory tract, and the stenotic site is basically consistent with the obstructive site in the state of sleep apnea. It is further indicated that CT scan of upper respiratory tract has important clinical value in the diagnosis of obstruction and stenosis in patients with OSAHS.
【作者單位】： 唐山職業(yè)技術學院;
【基金】：河北醫(yī)科大學 唐山職業(yè)技術學院資助
【分類號】：R766

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