儿童阻塞性睡眠呼吸暂停低通气综合征两种腺样体检查方法的对比研究

Comparative study on two kinds of methods for evaluating the volume of adenoids among children with obstructive sleep apnea hypopnea syndrome

目的比较观察两种检查方法对阻塞性睡眠呼吸暂停低通气综合征患儿腺样体大小的评估和诊断效果。方法33例阻塞性睡眠呼吸暂停低通气综合征患儿,分别行多导睡眠仪监测、立卧位鼻咽侧位照片、纤维鼻咽镜检查及鼻内镜检查,比较各项检测结果,分析仰卧位和立(坐)位时腺样体体积与鼻咽部、后鼻孔相互关系的变化规律。结果立位和卧位检查时,患儿鼻咽侧位片所显示的腺样体体积无明显差异(P>0.05);立位鼻内镜及纤维鼻咽镜检查、卧位鼻内镜结果配对t检验P<0.05,差异具有统计学意义且呈线性相关。结论鼻内镜检查对腺样体与鼻咽部、后鼻孔相互关系的评价效果明显优于鼻咽侧位片,而在立位、仰卧位时,腺样体与鼻咽部、后鼻孔的相互关系有显著差异。仰卧位鼻内镜检查对腺样体的评估效果更理想。

Obstructive To compare the validity of two kinds of methods for evaluating the volume of adenoids among children with obstructive sleep apnea hypopnea syndrome （OSAHS） based on a clinical trial. Methods Included in this study were 33 children cases with OSAHS, with their condition diagnosed and monitored by polysomnography （PSG）, lateral nasopharyngx radiograph in the posture of supine position and upright （or sitting） positions, and endoscopies with both of flexible fiberoptic nasolaryngoscope and nasal endoscope. Then, a comparative analysis was made to evaluate the difference of adenoidal volume between supine position and upright position, supplemented by a correlative study on the association of adenoidal volume changes in different positions with nasopharyngeal cavity and choana. Results There was no significant difference in the volume of adenoids between in the supine position and in upright position as shown on the nasopharyngeal lateral plain films （P〉0.05）, while significant differences could be seen when the cases were examined by both of flexible fiberoptic nasolaryngoscope and nasal endoscope taken in such different positions and analyzed by a paired t test among themselves （P〈 0.05）. Conclusions Nasal endoscopy is superior to lateral nasopharyngx radiography for the evaluation of the volume of adenoids and the association of adenoidal volume changes in different postures with nasopharyngeal cavity and choana. In different postures such as supine position and upright one, there is a significant difference in the relationship among the volumes of adenoids with nasopharyngeat cavity and choana. Nasal endoscopy carried Out in the position of supine is much more efficient for evaluation of adenoidal volume.