阻塞性睡眠呼吸暂停低通气综合征定位诊断之惑

doi:10.6040/j.issn.1673-3770.0.2017.007

摘要/Abstract

摘要： 阻塞性睡眠呼吸暂停低通气综合征阻塞部位的定位诊断,对选择合适的手术治疗方案,提高疗效,具有重要意义,但仍存在诸多疑惑。本文对目前临床上常用各种定位诊断方法:鼻咽喉常规检查、内镜检查+MULLER试验、上气道-食管持续压力测定、上气道影像检查及诱导睡眠内镜检查等的优缺点进行简要叙述。虽然临床上定位诊断方法很多,部分监测技术已十分精确,但还没有一种定位诊断方法能准确地为制定手术治疗方案提供依据或相对准确地预测手术疗效。结合相关文献及个人临床经验和研究,提出:复杂精细的定位检查尚不必列为常规项目,仅适用于部分病因未明或需要进行临床研究的病例。展望未来,仍应加强OSAHS发病机制的基础研究,定位诊断固然重要,但更重要的是定因诊断,即查明OSAHS上气道狭窄阻塞的成因,以期更有助于制定精准治疗方案,采用相对微创的手术达到较好疗效。

关键词: 睡眠呼吸暂停,阻塞性, 定位诊断, 手术

Abstract: The localization diagnosis of obstructive sleep apnea hypopnea syndrome(OSAHS)is important for selecting the appropriate surgical treatment, and improving curative effect. However, there still remains some confusion. Although there exist many commonly used localization diagnosis methods, including nose throat routine examination, endoscopy plus MULLER, upper-airway-esophageal continuous pressure measurement, upper-airway imaging examination, drug inducing sleep endoscopy, and so on, none of them can provide accurate evidence for surgical treatment or predict the outcome comparatively precisely. Based on relevant literature and the authors clinical experience and research, the author puts forward that elaborate localization diagnosis is not necessarily listed as a routine examination, and it applies only to cases with unknown causes or cases which need to be furthered studied. In the future, studies on the pathogenesis of OSAHS should be strengthened. The localization diagnosis is important, but what is more important is to detect the causes for airway stenosis and blockage, in order to develop more precise treatment plan, and achieve satisfactory outcomes by minimally invasive surgery.

Key words: Sleep apnea, obstructive, Localization diagnosis, Surgery

中图分类号:

R766.7

张湘民. 阻塞性睡眠呼吸暂停低通气综合征定位诊断之惑[J]. 山东大学耳鼻喉眼学报, 2017, 31(1): 4-7.

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