阻塞性睡眠呼吸暂停综合征患者舌后区上呼吸道CT测量

The lingual region upper airway CT scan of obstructive sleep apnea patients

目的 对阻塞性睡眠呼吸暂停综合征 (obstructivesleepapneasyndrome,OSAS)患者和健康人的舌体及舌后区上呼吸道的CT测量资料进行对比研究。方法 OSAS患者共 59例 ,年龄与性别相近的健康成年人 57名 ,采用螺旋CT对上呼吸道进行连续扫描 ,观察 2组舌后区上呼吸道形态学的差异 ,测量并比较舌后区气道和舌体各测量参数的差别。结果 患者多表现为气道前后径大于左右径、颏舌肌分离、舌根与软腭接触和舌正中切迹。患者组舌后区上呼吸道的横截面积、左右径明显小于对照组 ;咽侧壁软组织厚度、舌体宽度、颏舌肌宽度、舌骨舌肌宽度和舌体横截面积均明显大于对照组 ;呼吸道前后径、咽后壁软组织厚度和舌体长度与对照组相比无明显变化。结论 OSAS患者舌后区上呼吸道较健康对照组狭窄 ,除咽侧壁软组织增厚外 ,颏舌肌、舌骨舌肌和舌体宽度的增加也是造成舌后区上呼吸道狭窄的主要原因。

Objective To compare the lingual region upper airway CT scan results of OSAS patients and normal adults to explore if there are upper airway stricture in OSAS patients and the reason of stricture. Methods 59 patients with OSAS and 57 normal adults were included in the study. CT evaluated the lingual region upper airway with the use of a Philips Tomoscan AV Expander E1 spiral scanner. The shapes of lingual region upper airway were observed. The area and the dimensions of lingual region was studied, and the thickness of retropharyngeal and lateral pharyngeal tissue were evaluated too. The another focus area was tongue, and the evaluated data included the tongue width, genioglossus width, hyogolssus width, tongue length and tongue area. Results The data comparative results of OSAS and normal groups were as follows: the right to left diameter and area of OSAS patients′ lingual region upper airways were less than those of normal adults, the thickness of lateral pharyngeal, tongue width, genioglossus width, hyogolssus width and tongue area were more than those of normal adults. And there were not obviously difference between OSAS patients and normal adults in tongue length, anterior to posterior dimension and thickness of retropharyngeal wall tissue of upper airway. Conclusions The study suggests that there are obviously difference between the patients with OSAS and normal adult in lingual upper airway CT scan measure. And the anatomic stricture of lingual upper airway is one of the etiology of OSAS. The main reasons of stricture are increasing of thickness of lateral pharyngeal, tongue width, genioglossus width, hyogolssus width and tongue area.