OSAHS患者UPPP手术前后上气道形态学变化

Morphological changes of the upper airway in OSAHS patients with UPPP

目的研究阻塞性睡眠呼吸暂停低通气综合征(OSAHS)患者行悬雍垂腭咽成形术(UPPP)前后上气道形态学的变化。方法对经多导睡眠呼吸监测(PSG)确诊的32例OSAHS患者,应用多层螺旋CT在UPPP手术前后行上气道连续扫描,观察上气道形态学的改变,并根据手术疗效分级进行对比研究。结果OSAHS患者UPPP术后2～3年,平静呼吸时腭后区截面积和左右径增加;深吸气末腭后区和舌后区的截面积和左右径均增加,腭后区塌陷度减轻。各疗效组患者手术前后腭后区截面积的变化差异有统计学意义。结论OSAHS患者上气道阻塞平面主要位于腭后区者,行UPPP疗效较好。上气道CT测量数据可作为OSAHS患者行UPPP手术的参考标准。

Objective To explore the morphological changes of the upper airway in OSAHS patients with UPPP. Methods 32 patients with OSAHS were enrolled in this study, and their pharynxes were scanned by CT before and after UPPP for analysis. The patients were divided into four groups according to the therapeutic efficacy, and comparison was done among the four groups. Results 2-3 years after UPPP, the OSAHS patients＇ upper airway morphology changed. The cross-section areas and transverse diameters of the velo-pharyngeal were enlarged during normal respiration; at the end of deep inspiration, the cross-section areas and transverse diameters of the velo-pharyngeal and retro-pharyngeal were both enlarged, and the pharyngeal collapsibility was relieved. There were significant differences in the cross-section areas＇ changes of the velo-pharyngeal among the four groups. Conclusion It is better for OSAHS patient to accept UPPP only if their main constrictive cross-section is located at the velo-pharyngeal level. CT imaging of the upper airway can be one reference standard for choosing UPPP.