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[目的]通过上呼吸道三维立体的腔道模型,进行手术前、后的流体力学分析,从通气功能上评估多平面联合上呼吸道一期成形术对于IV型阻塞性睡眠呼吸暂停低通气综合征(OSAHS)治疗的效果和意义。[方法]利用三维重建软件Amira,根据36例IV型OSAHS患者CT检查所获得手术前、后三维重建测量数据的平均值,在几何图形软件Gambit中以有限积分法建立出上呼吸道立体几何近似模型。分别对上呼吸道一期成形术手术后、仅鼻腔手术后以及仅悬雍垂腭咽成形术后3种流场,以流体力学软件Fluent进行分析。[结果]上呼吸道一期成形术改善流场最为明显,其次为仅鼻腔手术。[结论]鼻腔通气功能状况非常大程度地影响整个上呼吸道气流性状,是诱发鼻咽部甚至口咽部湍流发生的重要因素之一。上呼吸道一期成形术对于IV型OSAHS患者,具有良好疗效。
[Objective] To evaluate the effects of multiplanar combined upper airway primary angioplasty on type IV obstructive sleep apnea-hypopnea syndrome (VAS) by means of fluid mechanics analysis before and after surgery through three-dimensional model of upper airway. OSAHS) treatment effect and significance. [Methods] Using the three-dimensional reconstruction software Amira, average values of three-dimensional reconstructions before and after surgery were obtained from CT examination of 36 patients with type IV OSAHS. The geometric upper approximation model of upper airway was established by finite integral method in geometry software Gambit . Three kinds of flow field after primary airway plasty surgery, post-nasal surgery and uvulopalatopharyngoplasty were respectively analyzed by Fluent fluid mechanics software. [Results] The upper airway primary angioplasty was the most obvious flow field, followed by nasal surgery alone. [Conclusion] The functional status of nasal ventilation affects the airflow characteristics of the upper respiratory tract to a great extent and is one of the important factors that induce turbulence in the nasopharynx and even the oropharynx. Upper airway primary angioplasty has good efficacy for type IV OSAHS patients.