阻塞性睡眠呼吸暂停低通气综合征患者上气道阻塞部位的临床分析

Clinical analysis of obstructive site in patients with obstructive sleep apnea hypopnea syndrom

[目的]确定阻塞性睡眠呼吸暂停低通气综合征(obstructive sleep apnea hypopnea syndrom,OSAHS)患者上呼吸道阻塞的好发部位,评价各阻塞部位的价值。[方法]对112例成人OSAHS患者的上呼吸道狭窄部位进行分析。[结果]①本组病例中Ⅱ型OSAHS最为常见,计有72例,在全部112例患者中占64.29%;②包括Ⅱ型和Ⅳ型,共有98例患者(87.5%)存在咽侧壁肥厚所致的咽腔狭窄,显示咽侧壁肥厚是导致OSAHS的最重要原因之一。[结论]①大部分OSAHS患者的阻塞部位只存在于口咽部,悬雍垂腭咽成形术(uvulopalatopharyngoplasty,UPPP)对大多数OSAHS患者有效;②咽侧壁因素在OSAHS的病因中占有重要地位,在OSAHS的治疗中,重视对咽侧壁的处理,可能提高UPPP的疗效。

[ Obsjective] To decide the predilection site in the upper airway and evaluate its value of the patients with Obstructive sleep apnea hypopnea syndrom（ OSAHS）. [ Method] Based on the standard which instituted by otorhinolaryngology department of Chinese Medical Association （CMS）, 112 patients were observed and studied. [ Results] There were 72 patients with Ⅱ type OSAHS （64.29%）, and 98 patients with upper airway Obstruction due to the factor of lateral wall of the oropharynx. [Conclusions] 1. Oropharynx is a main obstructive site in the most of the patients with OSAHS. 2. Pachynsis of the lateral wall of the oropharynx is an important factor in OSAHS. 3. Extending the distance in transverse of the oropharynx may improve the therapeutic effect of Uvulopalatopharyngoplasty （ UPPP）.