【摘要】：目的 探討腺樣體肥大兒童多導(dǎo)睡眠監(jiān)測(cè)與鼻咽側(cè)位X線片檢測(cè)數(shù)據(jù)的相關(guān)性,指導(dǎo)臨床診斷及確定手術(shù)指征。 方法 選擇年齡2-10歲腺樣體肥大兒童133名,所有觀察對(duì)象無鼻炎、鼻竇炎及鼻中隔偏曲等鼻腔病變,無顱腦疾病,最近一個(gè)月無急性上呼吸道感染。腺樣體檢查：拍攝仰臥位吸氣期鼻咽側(cè)位平片,靶—片距120cm,中心點(diǎn)在外耳道口前下各2cm處,下頜稍抬高。測(cè)量方法：在監(jiān)視器上用電子測(cè)量尺在鼻咽側(cè)位片上測(cè)量腺樣體的厚度及鼻咽腔的寬度,在標(biāo)準(zhǔn)鼻咽側(cè)位平片上,A表示腺樣體的厚度,為腺樣體下緣最凸點(diǎn)至枕骨斜坡顱外切線間的垂直距離。N1為腺樣體最凸部位的鼻咽腔寬度,即垂線的反向延長(zhǎng)線與硬腭后端或軟腭的交點(diǎn)和枕骨斜坡顱外切線的垂直距離；N2為翼板根部和斜坡顱外面的連接點(diǎn)與硬腭后上端的連線。采用冰島邦德安佰X100睡眠監(jiān)測(cè)儀、睡眠分析軟件,按國(guó)際通用標(biāo)準(zhǔn)導(dǎo)聯(lián)連接方法連續(xù)監(jiān)測(cè)患兒夜間至少7小時(shí)睡眠。監(jiān)測(cè)項(xiàng)目包括鼾聲、口鼻氣流、血氧飽和度、胸腹運(yùn)動(dòng)、體位等指標(biāo),進(jìn)行睡眠總結(jié)(監(jiān)測(cè)時(shí)間、睡眠期時(shí)間、總覺醒時(shí)間、總睡眠時(shí)間、打鼾次數(shù))；呼吸紊亂總事件(呼吸紊亂指數(shù)、AHI)；血氧總結(jié)(平均Sa02水平、LSaO2),觀察腺樣體的厚度與多導(dǎo)睡眠監(jiān)測(cè)的相關(guān)性。 結(jié)果 鼻咽側(cè)位X線片A/N比值測(cè)量數(shù)據(jù)0.7與PSG監(jiān)測(cè)指標(biāo)AHI呈正相關(guān),與最低血氧飽和度呈負(fù)相關(guān)。A/N比值≤0.7時(shí)與PSG監(jiān)測(cè)指標(biāo)無相關(guān)性 結(jié)論 A/N1與A/N2比值測(cè)量均能反映兒童腺樣體肥大程度,腺樣體肥大對(duì)兒童OSAHS影響明顯,扁桃體肥大不做為一個(gè)獨(dú)立的因素。
[Abstract]:Objective to investigate the correlation between polysomnography and lateral nasopharynx X-ray examination in children with adenoid hypertrophy. Methods 133 children aged 2-10 years with adenoid hypertrophy were selected. All the subjects were not affected by rhinitis, sinusitis and nasal septum deviation, no craniocerebral diseases, and no acute upper respiratory tract infection in the last month. Adenoid examination: the lateral nasopharynx plain film was taken in supine position during inspiratory period, the distance between target and film was 120 cm, the center point was at the anterior and inferior 2cm of the external auditory canal, and the mandible was slightly raised. Methods: the thickness of adenoid and the width of nasopharynx cavity were measured on the lateral nasopharynx film by electronic measuring ruler on the monitor. On the standard nasopharyngeal lateral plane film, A indicated the thickness of the adenoid. N1 is the width of nasopharynx cavity in the most protruding part of adenoid, that is, the reverse extension of perpendicular line to the intersection point of the posterior part of hard palate or soft palate and the vertical distance of the extracranial tangent of occipital bone to the posterior part of hard palate or soft palate. N2 is the connection between the base of the wing plate and the outside of the Clivus cranium and the upper end of the hard palate. With the help of Bandanbai X 100 sleep monitor and sleep analysis software, the children were monitored for at least 7 hours of sleep at night according to the international standard lead connection method. The monitoring items included snoring, mouth and nose airflow, blood oxygen saturation, chest and abdomen movement, posture and so on, and summarized sleep (monitoring time, sleep period, total awakening time, total sleep time, snoring times). Total events of respiratory disorders (respiratory disorder index, AHI); blood oxygen summary (average Sa02 level, LSaO2), to observe the correlation between adenoid thickness and polysomnography monitoring. Results A / N ratio of nasopharynx lateral radiographs was positively correlated with PSG monitoring index (AHI). There was no correlation between A/N1 and PSG when the ratio of A / N 鈮，

本文編號(hào)：2390976