Han D, Ye J, Wang J, Yang Q, Lin Y, Wang J
Department of Otorhinolaryngology, Beijing Tongren Hospital, Beijing 100730, China.
Zhonghua Er Bi Yan Hou Ke Za Zhi. 2001 Aug;36(4):301-4.
Determine the site(s) of upper airway obstruction and the influence of sleep stage on the pattern of obstruction with upper airway (UA) pressure measurement. Analyses the clinical value of UA pressure measurement and it's influenced factors.
30 OSAS patients underwent UA pressure measurement during polysomnography. Multisensory pressure catheters with five solid-state ultraminiature sensors were insert through patients' upper airway to esophagus, The sensors were located at the nasopharynx, oropharynx, tongue base, hypopharynx and esophagus and the lower limit of UA obstruction was determined relying on the observed pressure pattern.
(1) During inspiration, obstruction occurred associated with a increased negative inspiratory pressure inferior to the site of obstruction and a disappeared negative inspiratory pressure above the site of obstruction. (2) Three patterns of obstruction were observed. 1. The site of obstruction was located at the level of the palate. 2. The level of the palate and tonguebase obstruction all present. 3. Nasopharyngeal obstruction soft plate obstruction and tongue-pharynx obstruction all present. (3) The factors which affected these measurement are 1. The catheter were placed by observation with a fiberoptic endoscope to keep the sensors located at the correct position. 2. Catheter plugging with secretions need to be prevented.
UA pressure measurement can objectively identify the level of obstruction during sleep.
通过上气道（UA）压力测量确定上气道阻塞部位以及睡眠阶段对阻塞模式的影响。分析UA压力测量的临床价值及其影响因素。
30例阻塞性睡眠呼吸暂停低通气综合征（OSAS）患者在多导睡眠监测期间进行UA压力测量。将带有五个固态超微型传感器的多感觉压力导管经患者上气道插入至食管，传感器分别位于鼻咽、口咽、舌根、下咽和食管，根据观察到的压力模式确定UA阻塞的下限。
（1）吸气时，阻塞发生时阻塞部位下方的吸气负压增加，而阻塞部位上方的吸气负压消失。（2）观察到三种阻塞模式。1.阻塞部位位于腭水平。2.腭和舌根均存在阻塞。3.鼻咽阻塞、软腭阻塞和舌咽阻塞均存在。（3）影响这些测量的因素为：1.通过纤维内镜观察放置导管，以使传感器位于正确位置。2.需防止导管被分泌物堵塞。
UA压力测量可客观识别睡眠期间的阻塞水平。
