上气道CT测量在阻塞性睡眠呼吸暂停综合征临床外科治疗中的应用

The Measurement of Airway CT for Obstructive Sleep Apnea Syndrome in Clinical Application of Surgical Treatment

目的探讨上气道CT测量在阻塞性睡眠呼吸暂停综合征(OSAS)临床外科治疗中的应用。方法选择92例OSAS患者进行研究,根据鼻部及咽部CT测量结果将患者分为4组:以鼻腔狭窄为主而无软腭后区狭窄的OSAS患者,给予鼻腔扩容术治疗;以软腭后区狭窄为主而无鼻腔狭窄的OSAS患者,给予悬雍垂腭咽成形术(UPPP)手术治疗;同时合并鼻腔狭窄和以软腭后区狭窄为主的OSAS患者,本研究先给予UPPP手术治疗,术后恢复1周后,再次给予鼻腔扩容术治疗;无鼻腔狭窄并且无软腭后区狭窄的OSAS患者,给予持续正压通气治疗(CPAP)治疗,治疗后6个月对92例患者治疗前后进行比较。结果 92例患者CT示以鼻腔狭窄为主而无软腭后区狭窄的OSAS患者21例;以软腭后区狭窄为主而无鼻腔狭窄的OSAS患者50例;同时合并鼻腔狭窄和以软腭后区狭窄为主的OSAS患者18例;无鼻腔狭窄无软腭后区狭窄的OSAS患者3例。软腭后区,舌后区,会厌后区前后径、左右径、最小截面积由治疗前后差异均有统计学意义(P<0.05)。结论上气道CT可准确快速反映OSAS患者解剖学狭窄部位,为临床医生选择手术方式提供可靠依据。

Objective To explore the measurement of airway CT for obstructive sleep apnea syndrome （ OSAS） in clinical appli-cation of surgical treatment .Methods In the research,92 patients with OSAS were choiced.According to the nasal and pharyngeal CT meas-urement results ,the patients were divided into four groups：The OSAS patients were given priority to with narrow nasal cavity without narrow after the soft palate ,for the treatment of nasal cavity expansion;The OSAS patients were given priority to with narrow after the soft palate with-out narrow nasal cavity,giving（Uvulopalatopharyngoplasty,UPPP） surgery;The OSAS patients with narrow nasal cavity and after the soft pal-ate patients,first given UPPP surgery.After 1 week postoperative recovery ,again for the treatment of nasal cavity expansion;The OSAS pa-tients without nasal narrow and after the soft palate ,giving continuous positive airway pressure （CPAP） therapy treatment.Before and after treatment for 92 patients were compared after 6 months.Results According to the CT results for 92 patients,the case of OSAS patients given priority to with narrow nasal cavity without narrow after the soft palate were 21.The case of OSAS patients given priority to with narrow after the soft palate without narrow nasal cavity were 50,the case of OSAS patients with narrow nasal cavity and after the soft palate patients were 18,the case of OSAS patients without narrow nasal cavity and after the soft palate patients were 3.There were statistical difference significance before and after the treatment in the soft palate area retroglossal epiglottis region in anteroposterior ,left-right diameter,minimum cross-section-al area（P〈0.05）.Conclusion The nasal cavity and pharynx ministry CT can accurately and quickly reflect anatomical parts and provide reliable basis for clinicians to choose operation method .