CT扫描对阻塞性睡眠呼吸暂停综合征术前评估的价值

Significance of CT scanning in preoperative evalution of obstructive sleep apnea syndrome

目的 探讨CT扫描对阻塞性睡眠呼吸暂停综合征 (OSAS)术前评估的临床价值。 方法 选择我院 1998年 2月～ 2 0 0 2年 4月间行悬雍垂腭咽成形术 (UPPP)的 6 7例男性OSAS患者作为研究组 ,术前在清醒状态下平静呼吸时行螺旋CT扫描 ,取悬雍垂根部平面 (S1)、会厌上游离缘舌根后平面 (S2 )的面积作观察指标 ,并与 5 1例非OSAS患者 (对照组 )作比较 ,分析手术疗效与S1 、S2 平面面积的关系。 结果 OSAS患者S1 =14 4± 5 2mm2 ,S2 =2 2 3± 4 7mm2 ;非OSAS患者S1 =192± 5 7mm2 ,S2 =2 71± 5 3mm2 ,两者有显著性差异 (P <0 .0 1) ,提示OSAS患者在清醒状态下即有咽腔平面的狭窄 ;S1 面积较小者UPPP的疗效较好。 结论 咽部水平位螺旋CT扫描测量悬雍垂根部平面及会厌上游离缘舌根后平面的面积有助于OSAS阻塞部位的诊断 ,对手术方法的选择有指导意义。

Objective To explore the significance of CT scanning in preoperative evalution of obstructive sleep apnea syndrome(OSAS). Methods Sixty seven patients with OSAS (research group) and 51 patients with non-OSAS (control groap) were studied. The areas of uvular and lingual plane of each case were measured in conscious state by CT horizontal scanning, respectively.The data of areas of two groups were compared. The relation between curative effect of uvulopalatopharyngoplast (UPPP) and areas of uvular and lingual plane were analysed.Results The area of uvular and lingual plane was 144±52mm 2, 223±47mm 2 in research group,and 192±57mm 2,271±53mm 2in contuol group, respectively. There were singificant differences between them(P<0.01).The curative effect of UPPP in the patients with smaller area of uvular plane was better. Conclusion CT horizontal scanning on pharyngeal planes has an instructive significance for diagnosis and surgical operation in patients with OSAS.