[阻塞性睡眠呼吸暂停低通气综合征患者鼻咽部气体摄取横截面积的声反射检查及意义]

[OSAHS patient gas up-take cross-sectional area nasopharynx sound reflection examination and significance].

作者信息

Hu Jiandao, Lang Juntian, Liao Jianchun, Yu Wanjun, Zhang Jianyao, Jiang Tao, Cao Cheng, Zhou Shao, Ren Dong

机构信息

Department of Otolaryngology, Yinzhou People's Hospital, Ningbo, 315040, China.

出版信息

Lin Chuang Er Bi Yan Hou Tou Jing Wai Ke Za Zhi. 2011 Oct;25(20):936-8.

PMID:22239056

Abstract

OBJECTIVE

To explore a simple and accurate method for localization of upper airway obstruction in patients with obstructive sleep apnea-hypopnea syndrome (OSAHS) and provide instructions for surgical treatment.

METHOD

Fifty OSAHS patients confirmed by PSG underwent acoustic rhinometric and pharyngometric assessment by Eccovision. The parameters were recorded, including nasal minimal cross-sectional area (NMCA), distance of MCA from the nostril (DCAN), minimum cross-sectional area at the nasal valve(MCA), nasal resistance (NR) and nasal volume from 0 to 6 cm from the nostril (NCV), as well as pharyngeal cross-sectional area (CSA) and volume from 4.8 to 15.0 cm. The sensitivity and specificity of acoustic rhinometry and pharyngometry on localization of airway obstruction was determined by a comprehensive imaging and endoscopic study.

RESULT

In 50 cases with severe OSAHS, NMCA, DCAN, MCA, NCV, NR were (0.61 +/- 0.35) cm2, (2.06 +/- 0.12) cm, (0.87 +/- 0.12) cm2, (9.24 +/- 2.31)cm3 and (0.51 +/- 0.32)kPa/(L x min), respectively. Pharyngeal CSA and volume were statistically significantly lower than that in control group (P < 0.01). The value of DCAN was (2.06 +/- 0.12) cm, (9.50 +/- 4.08) cm, (13.10 +/- 2.52) cm in type I II, III patient, respectively. Compared with the control group, the difference was statistically significant.

CONCLUSION

Acoustic rhinometry and pharyngometry is a simple and safe method in localization of airway obstruction in patients with OSAHS.

摘要

目的

探索一种简单、准确的方法来定位阻塞性睡眠呼吸暂停低通气综合征（OSAHS）患者上气道阻塞部位，并为手术治疗提供指导。

方法

50例经多导睡眠监测（PSG）确诊的OSAHS患者接受了Eccovision声学鼻测量和咽测量评估。记录相关参数，包括鼻最小横截面积（NMCA）、鼻最小横截面积距鼻孔的距离（DCAN）、鼻瓣膜处最小横截面积（MCA）、鼻阻力（NR）以及鼻孔0至6 cm处的鼻容积（NCV），还有4.8至15.0 cm处的咽横截面积（CSA）和咽容积。通过综合影像学和内镜研究确定声学鼻测量和咽测量对气道阻塞定位的敏感性和特异性。

结果

50例重度OSAHS患者中，NMCA、DCAN、MCA、NCV、NR分别为（0.61±0.35）cm²、（2.06±0.12）cm、（0.87±0.12）cm²、（9.24±2.31）cm³和（0.51±0.32）kPa/（L·min）。咽CSA和咽容积在统计学上显著低于对照组（P<0.01）。Ⅰ型、Ⅱ型、Ⅲ型患者的DCAN值分别为（2.06±0.12）cm、（9.50±4.08）cm、（13.10±2.52）cm。与对照组相比，差异具有统计学意义。