鼻腔手术对OSAHS患者治疗效果的数值分析

Numerical simulations for the curative effect of the nasal surgery on patients with OSAHS

对3名伴有鼻阻塞的OSAHS患者术前术后的上气道结构包含软腭组织进行三维重构,采用数值模拟的方法研究这3名患者手术前后,上气道气流分布以及软腭的运动情况,分析鼻腔手术对OSAHS患者的治疗效果。3名患者手术后鼻腔通气程度均得已改善。两名轻度OSAHS患者手术后上气道阻力减小,软腭位移均比术前减小,这些变化均有助于缓减呼吸时气流受限情况。而第3名重度患者手术后上气道阻力和软腭位移反而增加,这将会进一步加重气道的阻塞程度。鼻部手术对OSAHS患者的治疗效果取决于上游鼻腔通气程度的改善能否对下游咽腔产生有益的影响。数值模拟结果与PSG监测结果及其主诉情况相符,与现阶段临床有关的研究结论相一致,能够间接反映术后气道通气程度以及打鼾症状是否改善,为进一步解决临床的疑难问题提供了理论依据。

The upper airway structure containing soft palate organizations of three OSAHS patients with nasal obstruction would be reconstructed to study the airflow distribution and movement of the soft palate before and after surgery using numerical simulation method. The curative effect would be analyzed for the nasal surgery on patients with OSAHS. The degree of nasal obstruction in three patients has been improved after surgery. For two patients with mild OSAHS,the resistance of upper airway and the dis- placement of soft palate decreases after surgery. These changes are contributing to the mitigation of the respiratory airflow limitation. For the third of patients with severe OSAHS, the resistance of upper airway and the displacement of soft palate actually increased after surgery, which will further increase the degree of airway obstruction. The curative effect of nasal surgery on patients with OSAHS depends on whether the improvement of nasal obstruction benefiting the pharynx. Numerical simulation results match the results of PSG test,chief complaint and clinical findings. It can indirectly reflect the degree of nasal patency and improvement of snoring symptoms which can provide a theoretical basis to solve the clinical problems.