正常成人上呼吸道咽壁顺应性定量评估

Quantitative evaluation of the upper airway resilience in adults

目的 探讨利用纤维内镜辅以计算机图像测量技术定量评估成人上呼吸道咽壁顺应性的可能性。方法 正常男性成年30人,以纤维内镜观察平静呼吸和上呼吸道不同负压水平时上呼吸道各平面形态变化并照相,图像分析软件测量其横截面积、前后径、左右径,计算总的咽壁顺应性、咽侧壁顺应性和咽前后壁顺应性。结果 较腭后区咽壁顺应性明显大于舌后区咽壁顺应性。随呼吸道内负压水平的增加,测算获得的咽壁顺应性值也明显增加。咽侧壁顺应性明显大于咽前后壁顺应性。结论 该技术可以实现上呼吸道各平面咽壁顺应性的定量评估,正常人的上呼吸道咽壁顺应性在不同的呼吸道内负压状态下存在明显差别,临床评估OSAS病人咽壁顺应性时应规范化。

Objective To explore the possibility of quantitative evaluation of upper airway resilience by fibre endoscope with Muller maneuver, and to study the resilience difference at all levels of the pharyngeal wall. Methods Thirty normal male adults were included in the study. The fibre endoscopic photos were taken on palate and lingua region at different negative pressures during Muller maneuver. The cross section area, the arrowy and coronal dimension of palate and lingua region upper airway were studied, and the total pharyngeal wall resilience (TPWR), lateral pharyngeal wall resilience (LPWR) and anteroposterior pharyngeal wall resilience (APWR) at different levels of the upper airway were calculated. Results There was obvious PWR difference between the palate and lingua region upper airway. The TPWR, LPWR and APWR of the palate region upper airway were much more than those of the lingua region upper airway. There was significant PWR difference among different upper airway negative pressure levels. The LPWR was much more than APWR in the palate and lingua region upper airway. Conclusion Quantitative data of pharynx wall resilience can be obtained by fibre endoscope with Muller maneuver assisted by computers. And there are obvious TPWR, LPWR and APWR differences at different sites of the upper airway and different upper airway negative pressure levels. The evaluation of pharyngeal wall resilience should be done in standardized maneuver.