[实时CT扫描与纤维喉镜技术在阻塞性睡眠呼吸暂停低通气综合征气道阻塞部位判定中的对比研究]

[Comparative study of determining the sites of airway obstruction in obstructive sleep apnea hypopnea syndrome between real-time CT scans and laryngofiberscope technology].

作者信息

Yan Zhi-qiang, Sun Jian-jun, Chen Xi, Yuan Wei, Lin Yong-sheng, Sun Yu-mei, Zhang Rong

机构信息

Graduate College, Anhui Medical University, Hefei, China.

出版信息

Zhonghua Yi Xue Za Zhi. 2012 Dec 25;92(48):3389-92.

PMID:23327696

Abstract

OBJECTIVE

To compare 256-layer spiral computed tomography (CT) scan in sleep and laryngofiberscope technology for locating obstructive sites of upper airway in patients with obstructive sleep apnea hypopnea syndrome, analyze their advantages and disadvantages and discuss the clinical application values.

METHODS

A total of 59 patients with OSAHS diagnosed by polysomnography underwent spiral CT scan in awake and drug-induced sleep states and laryngofiberscope examination in awake state to assess the sites of airway obstruction.

RESULTS

Real-time CT scans were completed successfully in all patients. There were airway obstruction at isolated retropalatal region (real-time CT revealing n = 26, laryngofiberscope revealing n = 34), retropalatal and retroglottal regions simultaneously (real-time CT revealing n = 19, laryngofiberscope revealing n = 10), retropalatal and epiglottal regions simultaneously (real-time CT revealing n = 6, laryngofiberscope revealing n = 2), retropalatal and retroglottal and epiglottal regions simultaneously (real-time CT revealing n = 7, laryngofiberscope revealing n = 3) and no airway obstruction (real-time CT revealing n = 1, laryngofiberscope revealing n = 10). There was not solitary airway obstruction at retroglottal or epiglottal region. The results of real-time CT scans and laryngofiberscope examination were statistically significant different in all regions, and real-time CT scanning compared with laryngofiberscope found more obstructive sites of upper airway [retropalatal region: 98.3% (n = 58) vs 81.4% (n = 48), χ(2) = 5.82, P < 0.05; retroglottal regions: 44.1% (n = 26) vs 22.0% (n = 13), χ(2) = 9.60, P < 0.01; epiglottal regions: 22.0% (n = 13) vs 8.5% (n = 5), χ(2) = 4.90, P < 0.05].

CONCLUSION

Compared with laryngofiberscope examination,real-time dynamic CT scans in drug-induced sleep state could get more information about anatomy changes of upper airway, providing relatively objective morphological basis for diagnosis and treatment of patients with OSAHS.

摘要

目的

比较256层螺旋计算机断层扫描（CT）睡眠扫描与纤维喉镜技术在阻塞性睡眠呼吸暂停低通气综合征患者上气道阻塞部位定位中的应用，分析其优缺点并探讨临床应用价值。

方法

选取59例经多导睡眠图诊断为阻塞性睡眠呼吸暂停低通气综合征的患者，分别在清醒状态和药物诱导睡眠状态下进行螺旋CT扫描，并在清醒状态下进行纤维喉镜检查，以评估气道阻塞部位。

结果

所有患者均成功完成实时CT扫描。孤立的腭后区气道阻塞（实时CT显示n = 26，纤维喉镜显示n = 34），腭后区和声门后区同时存在气道阻塞（实时CT显示n = 19，纤维喉镜显示n = 10），腭后区和声门上区同时存在气道阻塞（实时CT显示n = 6，纤维喉镜显示n = 2），腭后区、声门后区和声门上区同时存在气道阻塞（实时CT显示n = 7，纤维喉镜显示n = 3），无气道阻塞（实时CT显示n = 1，纤维喉镜显示n = 10）。声门后区或声门上区无孤立性气道阻塞。实时CT扫描与纤维喉镜检查结果在所有区域均有统计学差异，实时CT扫描与纤维喉镜检查相比发现更多的上气道阻塞部位[腭后区：98.3%（n = 58）对81.4%（n = 48），χ(2)=5.82，P < 0.05；声门后区：44.1%（n = 26）对22.0%（n = 13），χ(2)=9.60，P < 0.01；声门上区：22.0%（n = 13）对8.5%（n = 5），χ(2)=4.90，P < 0.05]。