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目的探讨CT扫描在阻塞性睡眠呼吸暂停综合征(OSAS)手术前后的临床价值。方法选择36例中重度OSAS患者,采用Siemens Somatom螺旋CT扫描机,自患者鼻咽顶部到声门之间的区域进行扫描,以悬雍垂根部为界将口咽部分为口咽上部与口咽下部2部分,测量并计算这2个平面的横截面积,并与50例健康人(对照组)作比较,根据阻塞部位的不同将其分为Ⅰ型(单纯口咽上部阻塞),Ⅱ型(口咽上部+口咽下部阻塞)。通过手术前后咽腔截面积和呼吸紊乱指数(AHI),血氧饱和度(SaO2)变化比较2型患者术后的客观疗效。结果Ⅰ型:口咽上部截面积较术前明显扩大(P<0.005);平均AHI从49.1降至19.2,最低SaO2从64.6%提高至80.6%(均P<0.01);Ⅱ型:口咽上部截面积较术前明显扩大(均P<0.005),口咽下部无明显变化(P>0.05),AHI从52.7降至37.2,最低SaO2从59.8%提高至68%(均P<0.05),2型手术有效率分别为85%和33%(P<0.01)。结论OSAS患者手术前后CT扫描确定口咽阻塞部位有助于提高手术疗效和术后疗效评估。
Objective To investigate the clinical value of CT scanning before and after obstructive sleep apnea syndrome (OSAS). Methods Thirty-six patients with moderate-to-severe OSAS were selected and scanned with Siemens Somatom spiral CT scanner from the top of the nasopharynx to the glottis. The oropharyngeal part of the oropharyngeal part was taken from the upper part of the uvula and the oropharynx In the lower part 2, the cross-sectional area of these two planes were measured and calculated, and compared with 50 healthy people (control group). According to the different occlusion sites, they were divided into Ⅰ type (upper part of simple oropharyngeal obstruction), Ⅱ (Upper oropharyngeal obstruction). The postoperative objective curative effect of type 2 patients was compared by the change of pharyngeal cavity area, respiratory distress index (AHI) and blood oxygen saturation (SaO2) before and after surgery. Results Type Ⅰ: The cross-sectional area of the oropharynx was significantly larger than that before operation (P <0.005); the average AHI was decreased from 49.1 to 19.2, the minimum SaO2 increased from 64.6% to 80.6% (all P <0.01); Type Ⅱ: (P <0.05), AHI decreased from 52.7 to 37.2, and the minimum SaO2 increased from 59.8% to 68% (both P <0.05) The operative efficiencies were 85% and 33%, respectively (P <0.01). Conclusion CT scan of OSAS patients before or after the operation to determine the oropharyngeal obstruction site will help to improve the efficacy of surgery and postoperative evaluation.