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目的针对儿童阻塞性睡眠呼吸暂停低通气综合征(OSAHS)诊断中存在的问题,对模拟内镜技术在检查和诊断中的作用和价值进行观察和评估。方法选择2006年7月至2010年12月OSAHS患儿38例,其中男性20例,女性18例;年龄6~7岁,平均年龄6.44岁。采用模拟内镜技术对患儿行鼻咽部检查,合并分泌性中耳炎的为Ⅰ组(n=18),无合并中耳炎的为Ⅱ组(n=20)。观察腺样体的最突出部位的厚度、鼻咽腔前后径、腺样体厚度/鼻咽腔前后径(A/N)比值及腺样体外侧沟的深度。结果Ⅰ组和Ⅱ组儿童腺样体厚度分别为(16.21±1.74)mm、(15.75±1.44)mm;鼻咽腔前后径分别为(19.52±1.37)mm和(19.36±1.27)mm;A/N比值分别为0.85±0.06和0.83±0.05;差异均无统计学意义(P>0.01)。腺样体外侧沟的深度分别是(1.69±0.52)mm、(2.90±0.68)mm,Ⅰ组腺样体外侧沟的深度明显浅于Ⅱ组(P<0.01)。结论腺样体肥大合并分泌性中耳炎与腺样体的形态有关;模拟内镜技术不但可以测量腺样体厚度,还可以测量和评估腺样体的形态。对诊断儿童OSAHS有重要的价值,是值得临床推广的方法。
Objective To investigate the problems in diagnosis of obstructive sleep apnea-hypopnea syndrome (OSAHS) in children and to observe and evaluate the role and value of simulated endoscopy in the examination and diagnosis. Methods From July 2006 to December 2010, 38 children with OSAHS were selected, including 20 males and 18 females. The patients were 6-7 years old with a mean age of 6.44 years. Nasopharyngeal examination was performed in children with simulated endoscopy. Group Ⅰ with secretory otitis media (n = 18) and group Ⅱ without otitis media (n = 20). Observe the thickness of the most prominent parts of the adenoid, anteroposterior diameter of the nasopharynx, adenoid thickness / anterior / posterior nasal pharynx (A / N) ratio and the depth of the lateral glandular groove. Results The thickness of adenoids of children in group Ⅰ and group Ⅱ were (16.21 ± 1.74) mm and (15.75 ± 1.44) mm, respectively. The anteroposterior diameter of nasopharyngeal cavity were (19.52 ± 1.37) mm and (19.36 ± 1.27) mm respectively. The A / N ratio were 0.85 ± 0.06 and 0.83 ± 0.05, respectively, with no significant difference (P> 0.01). The depth of the lateral groove of adenoid was (1.69 ± 0.52) mm and (2.90 ± 0.68) mm respectively. The depth of lateral groove of adenoid was significantly lighter in group Ⅰ than that in group Ⅱ (P <0.01). Conclusions Adenoid hypertrophy with secretory otitis media is related to the morphology of adenoids. Simulated endoscopy can not only measure the thickness of adenoids, but also measure and evaluate the morphology of adenoids. The diagnosis of children with OSAHS has important value, is worthy of clinical promotion methods.