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阻塞性睡眠呼吸暂停综合征(obstructive sleep apnea hypopnea syndrome,OSAHS)的发病主要是由于上气道解剖上的狭窄和呼吸控制功能失调而造成。OSAHS症状正确诊断对于OSAHS的有效治疗十分重要。上呼吸道CT对OSAHS患者上气道狭窄部位扫描定位是临床上的重要诊断手段,如何分析CT扫描数据,对于正确判断OSAHS具有意义。本研究以健康人群常规CT扫描数据确立了检测指标的正常范围,选用58例OSAHS患者进行上呼吸道CT。研究结果表明:58例患者中13例无明显狭窄,45例患者存在横截面狭窄,统计发现狭窄层面共71个。在45例OSAHS患者中,26例为单个层面狭窄,其中15例为软腭后区狭窄,2例为悬雍垂区狭窄,4例为舌后区狭窄,5例为会厌后区狭窄;在45例OSAHS患者中,16例患者存在两个层面的联合狭窄,一般为相邻部位,其中6例为软腭后区+悬雍垂区狭窄;6例悬雍垂区+舌后区狭窄,4例为舌后区+会厌后区狭窄;另外,CT扫描显示2例OSAHS患者的层面狭窄成3个部位的联合,分别为软腭后区+悬雍垂区+舌后区;而2例患者的层面狭窄为4个部位联合。进一步对15例清醒状态和睡眠呼吸暂停状态下的OSAHS患者进行的上呼吸道CT扫描对比发现,清醒状态下的上呼吸扫描提示的狭窄部位与睡眠呼吸暂停状态下发生的阻塞部位基本吻合。从本研究结果,我们认为大多数OSAHS患者存在上呼吸道的解剖性狭窄,且狭窄部位基本与睡眠呼吸暂停发生状态下阻塞部位相一致,进一步说明上呼吸道CT扫描对OSAHS患者阻塞及狭窄的定位具有重要临床诊断价值。
The incidence of obstructive sleep apnea hypopnea syndrome (OSAHS) is mainly due to anatomic stenosis of the upper airway and dysfunction of respiratory control. Correct diagnosis of OSAHS Symptoms are important for effective treatment of OSAHS. Upper respiratory tract CT scan of OSAHS patients with upper airway stenosis is a clinically important diagnostic tool, how to analyze the CT scan data, for the correct judgment of OSAHS meaningful. In this study, the normal range of detection index was established by routine CT scan data of healthy people. 58 patients with OSAHS were selected for upper respiratory tract CT. The results show that: 58 cases of 13 patients without significant stenosis, 45 patients with cross-sectional stenosis, a total of 71 were found stenosis level. Of the 45 patients with OSAHS, 26 were single-level stenoses, of which 15 were stenosed soft posterior commissures, 2 were stenosed in the uvula, 4 were posterior lingual stenosis, and 5 were posterior epigranch stenosis. At 45 Sixteen patients with OSAHS had two levels of stenosis, generally adjacent to each other, of which 6 were stenosed soft posterior region + uvula; 6 were uvular and posterior lingual stenosis, 4 were In addition, the CT scan showed that the level of the two patients with OSAHS narrowed into three parts of the joint, respectively, the soft palate posterior + uvula zone + posterior lingual area; and 2 patients with the level Narrow joint for the 4 parts. Further comparison of upper airway CT scans of 15 OSAHS patients with conscious and sleep apnea states found that the stenosis prompted by the upper respiratory scan in awake state basically coincides with the occlusion site occurred in sleep apnea. From the results of this study, we believe that most OSAHS patients have anatomical stenosis of the upper respiratory tract, and the stenosis site is basically consistent with obstructive site of sleep apnea, further illustrating the location of upper airway CT scan for occlusion and stenosis in patients with OSAHS Important clinical diagnostic value.