阻塞性睡眠呼吸暂停低通气综合征患者CPAP治疗前后上气道顺应性的CT改变

doi:10.6040/j.issn.1673-3770.0.2018.294

摘要/Abstract

摘要： 目的通过CT测量,分析阻塞性睡眠呼吸暂停低通气综合征(OSAHS)患者无创正压通气(CPAP)治疗前后上气道顺应性的改变在影像学方面的表现,探讨无创正压通气治疗对各阻塞腔最小横截面积顺应性的作用效果。方法选择确诊为OSAHS并意愿行CPAP治疗的95例患者(男58例,女37例),分别于进行6个月CPAP治疗前后,将患者平静呼吸及闭口堵鼻深吸气(Muller试验)时,行上气道CT扫描,测量鼻咽腔、腭咽腔、舌咽腔、喉咽腔的最小横截面积。测量计算各阻塞腔最小横截面积顺应性,比较各阻塞腔最小横截面积顺应性大小。比较计算各阻塞腔最小横截面积CPAP治疗前后顺应性的改变。结果 CPAP治疗前后,各阻塞腔最小横截面积顺应性均不同,其中腭咽区、喉咽区顺应性较大, P<0.01,差异有统计学意义。CPAP治疗6个月后患者鼻咽腔、腭咽腔、舌咽腔、喉咽腔顺应性均较治疗前降低,t值分别为6.743、69.601、36.724、12.242,P均<0.01,差异有统计学意义。腭咽区、舌咽区顺应性下降最明显, 差异有统计学意义(P<0.01)。结论 OSAHS患者各阻塞腔顺应性不同,腭咽腔、喉咽腔顺应性较大。CPAP治疗6个月后,各阻塞腔顺应性均减小,其中腭咽区、舌咽区顺应性改变较大。

关键词: 睡眠呼吸暂停,阻塞性, 正压呼吸通气治疗, 阻塞腔, 顺应性, CT测量

Abstract: Objective To assess changes using computed tomography(CT)in obstructive sleep apnea-hypopnea syndrome(OSAHS)patients upper airways before and after noninvasive positive pressure ventilation was conducted. To investigate the effect of noninvasive positive pressure ventilation on the compliance of the minimum cross-sectional area of each block. Methods The subjects were 95 people(58 males and 37 females)that had been diagnosed withOSAHS. The minimum cross-sectional area of the nasopharyngeal cavity, palatopharyngeal cavity, glossopharyngeal cavity, and throat cavity was measured using CT scanning of the airway. The Muller test, small breaths and closed nasal inhalation, was used both before continuous positive airway pressure(CPAP)treatment and after 6 months. The compliance of the minimum cross-section area of each block was measured and calculated. The minimum cross-section area compliance of each block was compared. Results Before and after CPAP treatment, the minimum cross-sectional areas of the obstruction compliance weredifferent. This includedthe velopharyngeal, pharyngeal, laryngeal compliance.The difference, P<0.01 was statistically significant. Following6 months of CPAP treatment, patients with a nasopharyngeal cavity and pharyngeal cavity or a pharynx cavity and hypopharyngeal cavity hadlower compliance than before treatment. Thet values were 6.743, 69.601, 36.724, 12.242.Thedifference was statistically significant, P<0.01. Conclusion Before and after CPAP treatment, the conformance was different, and both the palatopharyngealand laryngopharyngeal cavity were more compliant. Following6 months of CPAP treatment, the compliance of all obstructive cavities reduced.The compliance of the velopharyngeal and glossopharyngeal areas displayed the most significant changes.

Key words: Sleep apnea, CPAP treatment, Obstruction cavity, Compliance, CT measurement

中图分类号:

R766.43

吕丹,孙铭宏,于雪莹,张艳青,梅栩彬,刘文君. 阻塞性睡眠呼吸暂停低通气综合征患者CPAP治疗前后上气道顺应性的CT改变[J]. 山东大学耳鼻喉眼学报, 2020, 34(1): 46-49.

L(¨overU)Dan, SUN Minghong, YU Xueying, ZHANG Yanqing, MEI Xubin, LIU Wenjun. CT changes in upper airway compliance in patients with obstructive sleep apnea-hypopnea ayndromeusing CPAP[J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2020, 34(1): 46-49.

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