咽通道管治疗阻塞性睡眠呼吸暂停综合征咽腔的变化

Pharynx changes in obstructive sleep apnea syndrome after the treatment with pharyngeal passage tube

目的 :了解阻塞性睡眠呼吸暂停综合征 (OSAS)用咽通道管治疗前后咽腔的变化 ,探讨其应用价值。 方法 :应用CT结合Muller试验检查咽通道管治疗OSAS (2 2例 )前后咽腔大小改变 ,并监测其疗效。 结果 :①平静呼吸时 ,腭咽、舌咽最小截面积分别为 (10 2 .4 9± 2 2 .78)mm2 、(198.2 4± 5 4 .35 )mm2 ;②Muller试验时 ,腭咽、舌咽最小截面积分别为 (10 .37± 11.6 8)mm2 、(96 .36± 2 7.78)mm2 ,咽腔阻塞阳性率分别为 95 .4 6 % (2 1/ 2 2 )、4 0 .91% (9/ 2 2 ) ;咽通道管治疗后咽峡最小截面积分别为 (10 4 .2 1± 4 .16 )mm2 、(138.5 3± 30 .2 7)mm2 ,咽腔阻塞阳性率为 0 ;③治疗前后呼吸暂停低通气指数 (AHI)分别为 6 8.15± 17.6 1、2 8.34± 10 .6 8,最低血氧饱和度 (LSAT)为 (6 0 .2 4± 11.83) %、(80 .13± 12 .2 6 ) % ,睡眠时血氧饱和度超过 90 %时间百分率 (MT90 )为 (6 5 .2 7± 17.34) %、(92 .16± 6 .2 4 ) %。 结论

Objectives:To investigate and evaluate the therapeutic effects of pharynx configuration changes in obstructive sleep apnea syndrome (OSAS) after the treatment with pharyngeal passage tube. Methods: Twenty two OSAS pharynges were examined by computed tomography assisted with Muller maneuver before and after the treatment. Results: ① The minimal cross section of vel and tongue pharyngeal areas were (102.49±22.78)mm 2 and (198.24±54.35)mm 2 respectively at usual respiration; ②The vel and tongue pharyngeal areas were (10.37±11.68) mm 2 and (96.36±27.78 )mm 2 at Muller maneuver, the pharyngeal obstruction rates were 95.46%(21/22)and 40.91%(9/22). The areas were changed to(104.21±4.16) mm 2 and (138.53±30.27) mm 2 with pharyngeal passage tube, and the pharyngeal obstruction rate was 0;③The pre and post intervene apnea hypopnea index( AHI)were 68.15±17.61 and 28.34±10.68, the lowest oxygen saturation (LSAT) rates were(60.24±11.83)% and (80.13±12.26)%, the percentages of time that SaO 2 above 90% (MT 90 )were(65.27±17.34)% and (92.16±6.24)%. Conclusions: Pharyngeal passage tube can improve the pharyngeal obstructions and thus treat OSAS.