CT—MPR呼吸道測量在阻塞性睡眠呼吸暫停綜合征上呼吸道狹窄定位診斷中的意義
論著
作者：張永添等
[摘要] 目的 探討CT-MPR呼吸道測量在阻塞性睡眠呼吸暫停綜合征上呼吸道狹窄定位診斷中的意義。 方法 選取2012年5月～2014年4月我院接收的43例阻塞性睡眠呼吸暫停綜合征患者為實驗1組，33例阻塞性睡眠呼吸暫停發作時上呼吸道狹窄患者為實驗2組，另選取43例健康人為對照組。經螺旋CT對所有患者自鼻咽頂部至環狀軟骨下緣進行平掃檢測，同時采用MPR圖像處理技術對所有患者上呼吸道的4個平麵的橫截麵積、前後徑等指標進行測量，觀察對比對照組與實驗1組及實驗2組的上呼吸道測量數值。 結果 實驗1組的舌後區、懸雍垂區及軟齶後區的橫截麵積比對照組小，差異有統計學意義（P
[關鍵詞] 上呼吸道狹窄；阻塞性睡眠呼吸暫停綜合征；CT-MPR呼吸道測量
[中圖分類號] R766 [文獻標識碼] A [文章編號] 1673-9701（2015）08-0001-04
[Abstract] Objective To study the value of CT-MPR respiratory measurement in the location diagnosis of upper airway stricture of obstructive sleep apnea syndrome. Methods From May 2012 to April 2014， 43 cases of patients with obstructive sleep apnea syndrome were selected as the experimental group 1， 33 cases of patients with upper airway obstruction sleep apnea syndrome were selected as the experimental group 2， 43 cases of healthy people were selected as the control group. All patients were detected by spiral CT scan from the top of nasopharyngeal to the inferior border of the cricoid cartilage， the index of the 4 plane in patient’s upper respiratory tract such as cross sectional area， anteroposterior diameter were measured by the technology of MPR image processing， the measured values of upper respiratory tract of the control group， experimental group 1 and experimental group 2 were observed and compared. Results The cross sectional area of the lingual region， uvula region and posterior region of the soft palate in the experimental group 1 was smaller than that of the control group， and the difference in data between the two groups was statistically significant（P
[Key words] Upper airway stricture； Obstructive sleep apnea syndrome； CT-MPR respiratory measurement
阻塞性睡眠呼吸暫停綜合征又稱OSAS，屬於中老年群體多發病。據相關報道顯示，無論上呼吸道的舌後區、懸雍垂區等任何區域發生阻塞或狹窄現象，均可誘發阻塞性睡眠呼吸暫停綜合征。如患者上呼吸道狹窄部位定位不明確，其采用UPPP（懸雍垂齶咽成形術）治療的成功率僅為50%，重新對手術失敗病例的狹窄部位進行定位診斷發現，手術失敗患者上呼吸道有多處狹窄[1]。基於此，術前正確估計OSAS患者的上呼吸道狹窄部位，對實現對症治療、提升手術成功率極其有益。經螺旋CT對OSAS患者自鼻咽頂部至環狀軟骨下緣進行平掃檢測，同時采用MPR圖像處理技術進行輔助測量，能夠精確測定出患者的咽壁厚度、會厭後區、舌後區及懸雍垂區、軟齶後區的橫截麵積等[2]。既往報道顯示，OSAS患者與正常人的各CT呼吸道測量值有顯著的差異[3]。本研究基於既往研究所得出的上呼吸道CT測量正常值範圍，觀察對比OSAS患者與健康人的CT掃描測量結果，以分析CT-MPR呼吸道測量在定位診斷阻塞性睡眠呼吸暫停綜合征上呼吸道狹窄部位中的價值。