OSAHS患者上呼吸道狭窄或阻塞的上呼吸道CT诊断

CT Diagnosis of Upper Airway Stenosis or Choke in Patients with Obstructive Sleep Apnea Hypopnea Syndrome(OSAHS)

阻塞性睡眠呼吸暂停综合征(obstructive sleep apnea hypopnea syndrome,OSAHS)的发病主要是由于上气道解剖上的狭窄和呼吸控制功能失调而造成。OSAHS症状正确诊断对于OSAHS的有效治疗十分重要。上呼吸道CT对OSAHS患者上气道狭窄部位扫描定位是临床上的重要诊断手段,如何分析CT扫描数据,对于正确判断OSAHS具有意义。本研究以健康人群常规CT扫描数据确立了检测指标的正常范围,选用58例OSAHS患者进行上呼吸道CT。研究结果表明:58例患者中13例无明显狭窄,45例患者存在横截面狭窄,统计发现狭窄层面共71个。在45例OSAHS患者中,26例为单个层面狭窄,其中15例为软腭后区狭窄,2例为悬雍垂区狭窄,4例为舌后区狭窄,5例为会厌后区狭窄;在45例OSAHS患者中,16例患者存在两个层面的联合狭窄,一般为相邻部位,其中6例为软腭后区+悬雍垂区狭窄;6例悬雍垂区+舌后区狭窄,4例为舌后区+会厌后区狭窄;另外,CT扫描显示2例OSAHS患者的层面狭窄成3个部位的联合,分别为软腭后区+悬雍垂区+舌后区;而2例患者的层面狭窄为4个部位联合。进一步对15例清醒状态和睡眠呼吸暂停状态下的OSAHS患者进行的上呼吸道CT扫描对比发现,清醒状态下的上呼吸扫描提示的狭窄部位与睡眠呼吸暂停状态下发生的阻塞部位基本吻合。从本研究结果,我们认为大多数OSAHS患者存在上呼吸道的解剖性狭窄,且狭窄部位基本与睡眠呼吸暂停发生状态下阻塞部位相一致,进一步说明上呼吸道CT扫描对OSAHS患者阻塞及狭窄的定位具有重要临床诊断价值。

The obstructive sleep apnea hypopnea syndrome（OSAHS） is mainly caused by upper airway anatomy stenosis and respiratory control dysfunction.The correct diagnosis of OSAHS is very important for the effective treatment of OSAHS.The upper airway CT scan is an important clinical diagnostic method for upper airway stenosis in OSAHS patients.How to analyze the data of CT scan is of great significance to correctly judge OSAHS.In this study,the normal range of detection index was established based on the routine CT scan data of healthy people.58 patients with OSAHS were selected for upper respiratory tract CT.The results showed that 13 in 58 cases without obvious stenosis,45 cases with cross sectional stenosis,and statistics found that there were 71 narrow levels.In 45 patients with OSAHS,26 cases were single level stenosis,inclu ding 15 cases of soft palate stenosis,2 cases of uvula area stenosis,4 cases of lingual region stricture,and 5 cas es of stenosis of epiglottisregion.In 45 patients with OSAHS,16 patients had joint stenosis at two levels,generally they were adjacent parts,in which 6 cases were soft palate and uvula area stenosis,the other 6 cases were uvula area and retroglottal region stenosis,and the rest 4 cases were retroglottal region and epiglottis region stenosis.In addition,CT scan showed that 2 patients with OSAHS were narrowed into a joint of three sites.They were soft palate,uvula area and retroglottal region,respectively.While the horizontal stenosis of 2 patients were the combination of four sites.The comparison of 15 cases of OSAHS in awake and sleep apnea state with CT scan of upper respiratory tract found that the upper part of upper respiratory scanning under conscious state was consistent with the obstructive site of sleep apnea.In conclusion,we believed that most patients with OSAHS had an anatomic stenosis of the upper respiratory tract,and the stenosis site was consistent with the obstructive site of sleep apnea.It was further indicated that CT scan of upper respiratory tract had important clinical value in the location of obstruction and stenosis in patients with OSAHS.