新指标NS/TS在评估鼾症儿童鼻咽通气道的作用

The Function of New Indicators NS/TS in Assessing Nasopharyngeal Airway of Snoring Children

目的探讨将鼻咽自由通气道大小与气管通气道大小的比例(NS/TS)作为鼾症儿童"腺样体切除术"术前评估新指标的可行性。方法按标准入选150例鼾症儿童,分别行电子鼻咽内窥镜检查和数字化X线鼻咽部侧位片检查;通过鼻咽内窥镜检查获得的数字图像通过处理软件计算并评估鼻咽部的通气度(A/C);通过鼻咽侧位片检查获得数字图像,分别测量腺样体厚度与鼻咽部宽度的比例(A/N)以及NS/TS,分析这2个比例与电子鼻咽内窥镜下获得的鼻咽部通气度的相关性。结果电子鼻咽内窥镜下,A/C的平均水平为(0.14±0.01)(0.12~0.16);鼻咽侧位片下,A/N的平均水平为(0.78±0.09)(0.76~0.79),A/N与A/C的相关系数为0.110(P>0.05),尚不能认为A/N与A/C存在关联。新参数NS/TS的平均水平为(0.16±0.01)(1.14~0.18),NS/TS与A/C之间存在强相关关系(r=0.430,P<0.001)。结论新参数NS/TS可取代传统参数A/N,成为鼾症儿童"腺样体切除术"术前评估的有效指标之一;对于不能忍受鼻咽内窥镜检查的儿童,新参数可能替代鼻咽内窥镜检查作为金标准的补充。

Objective To explore the reliability of the new index,which is the ratio of nasopharynx free airway to trachea airway size（NS/TS）as the preoperative assessment for adenoidectomy in snoring children. Methods 150 cases of snoring children were selected according to the criteria and underwent the electronic nasopharyngeal endoscopy and X-ray digital photography of nasopharynx lateral view respectively. The digital images obtained by nasopharyngeal endoscopy were evaluated by the treatment software for airway to choana（A/C）. The adenoid to nasopharynx ratio（A/N）and NS/TS were measured through nasopharynx lateral images,and both compared with A/C. Results The correlation between A/C [mean value：（0.14±0.01）（0.12-0.16）]and A/N [mean value：（0.78±0.09）（0.76-0.79）]（r=0.110,P〉0.05）was unfounded,but there was a high correlation between NS/TS[mean value：（0.16±0.01）（1.14-0.18）]and A/C（r=0.430,P〈0.001）. Conclusions The new parameter,The NS/TS can replace the A/N as a more effective indication parameter in preoperative assessment of snoring children for adenoidectomy. Meanwhile,for children who can not tolerate nasopharyngeal endoscopy,NS/TS may replace nasopharyngeal endoscopy as a supplement to the gold standard.