山东大学耳鼻喉眼学报

• 论著 • 上一篇    下一篇

CT测量对阻塞性睡眠呼吸暂停综合征患者舌咽区气道阻塞诊断意义的再评估

王晓燕,李树华   

  1. 解放军沈阳军区总医院耳鼻咽喉头颈外科, 辽宁 沈阳 110016
  • 收稿日期:2014-01-14 出版日期:2014-04-16 发布日期:2014-04-16
  • 通讯作者: 李树华,主任医师。 E-mail:lishsy@sina.com
  • 作者简介:王晓燕。 E-mail:puxuedongtao@126.com
  • 基金资助:
    辽宁省科技攻关计划(2010225036)

Diagnosis value assessment of computered tomography in glossopharyngeal obstruction in obstructive sleep apnea hypopnea syndrome

WANG Xiao-yan, LI Shu-hua   

  1. Department of Otolaryngology & Head and Neck Surgery, General Hospital of Shenyang Military Area Command, Shenyang 110016, Liaoning, China
  • Received:2014-01-14 Online:2014-04-16 Published:2014-04-16

摘要: 目的    以置入鼻咽通气管后的多导睡眠呼吸监测(NPT-PSG)结果判定中重度阻塞性睡眠呼吸暂停综合征(OSAHS)患者舌咽区气道阻塞情况,并与螺旋CT的判定结果对比,评估CT扫描测量在舌咽区上气道阻塞判定中的作用。方法    经PSG检查确诊的中重度OSAHS患者65例,在鼻咽通气管置入后再次进行NPT-PSG,同时采用螺旋CT对上呼吸道进行连续扫描。就NPT-PSG 结果与CT扫描测量所得的舌咽区气道截面积进行相关性分析,并以睡眠呼吸暂停低通气指数(AHI)≥15次/h和舌咽区气道截面积<181mm2为参考标准判定舌咽区气道是否存在狭窄或阻塞,比较两种判定方法结果的异同。结果    NPT-PSG所得AHI和最低血氧饱和度(LSaO2)与舌咽区气道截面积无明显相关性,相关系数分别为0.02和0.085,P均>0.05。舌咽区气道截面积<181mm2提示舌咽狭窄者7例,无明显狭窄的例数为58例;NPT-PSG所得AHI≥15次/h提示舌咽区气道阻塞者37例,无明显阻塞者28例。以统计量kappa系数评价两种测量结果的一致性,Kappa系数为0.055,P>0.05,两者一致性较差。结论    螺旋CT测量和NPT-PSG判定舌咽区气道狭窄或阻塞一致性较差,临床判定舌咽区气道阻塞与否应结合多种方法综合判定。

关键词: 睡眠呼吸暂停, X线计算机, 阻塞性;多导睡眠呼吸监测;鼻咽通气管;气道阻塞;舌咽区;体层摄影术

Abstract: Objective    To compare NPT-PSG with computered tomography (CT) scan which was also used to evaluate the glossopharyngeal obstruction. Methods    Sixty-five patients with OSAHS diagnosed by PSG were enrolled in this study. All the patients were successfully examined by NPT-PSG and CT scan. The correlation analysis between NPT-PSG and glossopharyngeal airway cross area (S) were conducted. And the coincidence of diagnosing glossopharyngeal obstruction of the two methods was calculated. Results    There was no significant correlation between NPT-PSG and glossopharyngeal airway cross area, the correlation coefficient of AHI and LSaO2 with S was 0.02 and 0.085 respectively. There were 7 and 37 patients diagnosed as glossopharyngeal obstruction by CT and NPT-PSG respectively. The concordance of the two methods was poor, assessed by kappa coefficient 0.055, P>0.05. Conclusion     The coincidence between the CT scan and NPT-PSG is poor. Multiple diagnosis tool and aggregate analysis should be used in localization glossopharyngeal obstruction in OSAHS.

Key words: Polysomnography, Sleep apnea hypopnea syndrome, obstructive, Nasopharyngeal tube; Airway obstruction; Glossopharyngeal; X-ray computered tomography

中图分类号: 

  • R766.7
[1] 刘大炜,张宇,李成林,陈秀梅,宋西成. 加速康复外科在儿童OSAS围手术期中的应用[J]. 山东大学耳鼻喉眼学报, 2018, 32(5): 19-22.
[2] 吕旭琴,万文锦. 阻塞性睡眠呼吸暂停低通气综合征合并高血糖患者的围手术期血糖管理[J]. 山东大学耳鼻喉眼学报, 2018, 32(4): 100-104.
[3] 陈涛,刘善平,卢永田. 中耳炎鼓室窦CT分型与手术方式初探[J]. 山东大学耳鼻喉眼学报, 2018, 32(4): 14-16.
[4] 沈翎,林宗通,林兴,杨中婕. 儿童阻塞性睡眠呼吸暂停低通气综合征危险因素的[J]. 山东大学耳鼻喉眼学报, 2018, 32(2): 25-29.
[5] 李延忠,张泰. 关于儿童阻塞性睡眠呼吸暂停低通气综合征我们面临的问题[J]. 山东大学耳鼻喉眼学报, 2018, 32(2): 1-5.
[6] 张会芳,杨红珍. 经鼻持续气道正压通气对阻塞性睡眠呼吸暂停低通气[J]. 山东大学耳鼻喉眼学报, 2018, 32(2): 48-51.
[7] 许志飞,倪鑫. 重视阻塞性睡眠呼吸暂停低通气综合征儿童腺样体[J]. 山东大学耳鼻喉眼学报, 2018, 32(2): 9-13.
[8] 王岩,师晓丽. 变态反应与儿童OSAHS的关系[J]. 山东大学耳鼻喉眼学报, 2018, 32(2): 14-18.
[9] 杨微,郑莉,许志飞. 中重度阻塞性睡眠呼吸暂停低通气综合征儿童无创正压[J]. 山东大学耳鼻喉眼学报, 2018, 32(2): 19-24.
[10] 仇书要,刘大波,钟建文,杨李强. 儿童阻塞性睡眠呼吸暂停低通气综合征等离子[J]. 山东大学耳鼻喉眼学报, 2018, 32(2): 34-37.
[11] 钟建文,刘大波,罗向前,黄振云,仇书要,程超,杨李强,易新华,曾锦鸿. 可穿戴设备在儿童阻塞性睡眠呼吸暂停诊断中的应用[J]. 山东大学耳鼻喉眼学报, 2018, 32(2): 30-33.
[12] 李浩,李延忠,王岩. HIF-1α、VEGF在阻塞性睡眠呼吸暂停低通气综合征患者[J]. 山东大学耳鼻喉眼学报, 2018, 32(2): 43-47.
[13] 龚齐,张劼,赵屏屏. 鼻腔扩容术对慢性鼻-鼻窦炎伴睡眠呼吸暂停[J]. 山东大学耳鼻喉眼学报, 2018, 32(2): 52-55.
[14] 王红梅,李连贺. 神经心理量表联合事件相关电位对中、重度阻塞性睡眠呼吸[J]. 山东大学耳鼻喉眼学报, 2018, 32(2): 56-61.
[15] 刘大波. 重视儿童阻塞性睡眠呼吸暂停低通气综合征睡眠结构紊乱[J]. 山东大学耳鼻喉眼学报, 2018, 32(2): 6-8.
Viewed
Full text


Abstract

Cited

  Shared   
  Discussed   
No Suggested Reading articles found!