腭舌结构特点与改良腭咽成形及舌根消融术治疗重度OSAHS的临床意义

目的　探讨根据腭、舌部解剖结构应用低温等离子辅助行改良腭咽成形及舌根消融术治疗重度阻塞性睡眠呼吸暂停低通气综合征(OSAHS)的疗效并进行评价。 方法　对82例重度OSAHS患者用低温等离子辅助行改良腭咽成形（H-UPPP）及舌根消融术,术前行多导睡眠监测（PSG）：AHI>50,LSaO2<80%;纤维喉镜配合Muller's运动检查（FEMM）及MRI检查,患者均存在腭咽及舌根平面狭窄,术后6、12个月随访并行PSG监测等。 结果　术后6、12个月有效率分别为86.9%、80.2% ,术后与术前比较AHI值下降（P<0.01）,且LSaO2升高（P<0.05）,所有患者主观症状较术前明显改善,有高血压等并发症的患者大部分减轻甚至恢复正常。6例患者术后5～9 d不同程度出血,少数患者1～2月内有味觉稍减退、咽干、返流、咽异物感,后均恢复正常,1例术后第10 d出现肺动脉栓塞,经治疗后好转;其余患者无并发症出现。 结论　根据腭、舌部解剖结构应用低温等离子辅助行改良腭咽成形及舌根消融术治疗重度OSAHS,作为一种微创手术,具有出血少、创伤小,并发症少的优点,是可行、安全而有效的,可成为OSAHS患者手术治疗的主要选择,值得在临床上推广。     

儿童阻塞性睡眠呼吸暂停低通气综合征的手术治疗

阻塞性睡眠呼吸暂停低通气综合征（OSAHS）是由于上呼吸道狭窄或堵塞等病因所致，儿童患者上呼吸道狭窄或堵塞的主要原因为扁桃体和腺样体肥大。本文对36例儿童OSAHS患者采用手术治疗，取得满意效果，现报道如下：     

鼻部联合腭咽平面手术治疗阻塞性睡眠呼吸暂停低通气综合征的疗效分析

目的探讨鼻部联合腭咽平面手术治疗阻塞性睡眠呼吸暂停低通气综合征的效果。方法选择通过多导睡眠监测仪监测确诊的OSAHS患者（阻塞同时位于鼻部及腭咽平面）56例,一期行鼻部手术包括单纯鼻中隔偏曲矫正术15例、双侧下鼻甲部分切除术18例、鼻中隔偏曲矫正术加双侧下鼻甲部分切除术23例 二期再行悬雍垂腭咽成形术。其中12例重度夜间最低血氧饱和度〈50%的患者,先行经鼻持续气道正压治疗一周后再行手术治疗。结果治愈9例,好转34例,减轻13例,所有患者无手术并发症发生。结论鼻部联合腭咽平面手术治疗阻塞性睡眠呼吸暂停低通气综合征可取得良好效果。重度夜间最低血氧饱和度〈50%的患者先行经鼻持续气道正压治疗,能有效预防手术并发症的发生。     

正常成人上呼吸道CT测量及其意义

目的：确定正常人的上呼吸道CT扫描下各平面的横截面积、经线长度以及咽壁厚度，为临床服务。方法：无明显睡眠呼吸疾病史的成年人（男115、女110），采用Philips Tomoscan AV Expander E1螺旋CT，对鼻咽顶部到声门之间的区域进行连续扫描，测量软腭后区、悬雍垂后区、舌后区和会厌后区的气道横截面积、失状径、冠状径、咽侧壁和咽后壁软组织厚度，以单侧95％可信区间确定各测量指标的参考值。结果：在上呼吸道各个扫描平面，绝大多数气道的形状均为横椭圆形，冠状径大于失状径，在软腭后区、悬雍垂后区、舌后区和会厌后区中，失状径大于冠状径者分别占总人数的3．11％、10．67％、0．8％和0％。各年龄组间比较，绝大多数测量指标差异不显著，男子组和女子组间比较，除软腭后区外，大多数测量指标差异显著。故分别制定了男、女各测量指标的还范围。结论：成人上呼吸道CT测量以及正常范围的确定为临床判定OSAS患者上呼吸道解剖性狭窄的部位提供了客观依据，男性OSAS发病率明显高于女性有其相关的生理基础。     

阻塞性睡眠呼吸暂停低通气综合征临床治疗分析

目的：探讨综合治疗对阻塞性睡眠呼吸暂停低通气综合征（OSAHS）治疗的效果。方法：对120例OSAHS病人随机平均分为3组，综合组采用上气道狭窄部位手术加经鼻气道持续正压通气、减肥等行为疗法进行综合治疗，手术组采用上气道狭窄部位手术治疗，通气组采用单纯经鼻气道持续正压通气（NCPAP）治疗。以治疗前后睡眠紊乱指数（AHI）和最低血氧饱和度（ISaO2）等作为疗效判定指标，对比观察3组疗效。结果：综合治疗组有效率87．5％；手术组有效率62．5％；通气组有效率65％。经统计学处理，综合治疗组疗效显著优于手术组和通气组（P〈0．01）。结论：采用手术解除上气道狭窄病变，配合经鼻持续正压通气、减肥等综合治疗OSAHS，可显著提高治疗效果。     

阻塞性睡眠呼吸暂停低通气患者舌动脉CT成像测量及其意义

目的探讨阻塞性睡眠呼吸暂停低通气综合征(OSAHS)患者间舌动脉CT血管成像(CTA)特点,为临床中线舌部分切除手术提供参考。方法对93例OSAHS患者进行舌咽区上呼吸道CT扫描和舌动脉CTA成像测量,比较不同舌腭关系分型的OSAHS患者组各项测量参数的差异。结果 4组不同舌腭关系分型的OSAHS患者间年龄、AHI、LSaO2和舌宽无明显差别,但BMI、舌后区呼吸道截面积、舌宽、舌长和舌厚度存在明显差别。4组间舌动脉长度(mm)分别为93.6±15.84、95.9±16.39、99.6±15.19、110.0±12.16;舌盲孔区舌动脉深度(mm)分别为27.4±5.81、27.3±4.28、28.0±4.43、31.2±6.38;舌动脉间距(mm)分别为21.7±3.57、23.1±4.90、22.8±5.53、25.6±4.60,组间差异均显著。舌动脉深度和间距分别与舌厚和舌宽显著相关。结论不同舌腭关系分型的OSAHS患者间舌动脉走行和测量参数存在明显差别,差别的原因与舌体肥厚等解剖改变有关。     

改良腭咽成形术治疗阻塞性睡眠呼吸暂停综合征对白介素-6和内皮素-1的影响

目的观察改良腭咽成形术和悬雍垂腭咽成形术治疗阻塞性睡眠呼吸暂停综合征的疗效,及其对白介素-6（IL-6）和内皮素-1（ET-1）的影响。方法选取2007年1月至2013年12月在本院就诊的阻塞性睡眠呼吸暂停综合征（OSAHS）患者312例,按照手术方式不同分为传统治疗组和改良治疗组,每组各156例。传统治疗组予以传统的悬雍垂腭咽成形术,改良治疗组予以改良腭咽成形术。观察两组的手术疗效,及其对鼾声分级、嗜睡分级、IL-6和ET-1水平的影响。结果改良治疗组的总有效率为87.82%,传统治疗组的总有效率为76.28%,改良治疗组的疗效优于传统治疗组,差异有统计学意义（χ^2=6.290,P〈0.05）。治疗后两组的鼾声分级、嗜睡分级、IL-6和ET-1水平明显较治疗前降低（P〈0.01）,且改良治疗组的降低水平比传统治疗组更为明显,差异有统计学意义（P〈0.05或〈0.01）。结论改良腭咽成形术的疗效明显优于悬雍垂腭咽成形术,可能与保留悬雍垂和咽腔基本结构,降低了机体的炎症反应,保护了机体的内皮功能有关。     

OSAHS鼻咽联合手术围手术期咽腔间距解剖变化及临床意义

目的　观察并分析阻塞性睡眠呼吸暂停低通气综合征（OSAHS）鼻、咽联合手术围手术期咽腔间距解剖变化的规律,及其对术后治疗、气管切开术选择的临床指导意义。 方法　选择确诊为鼻、咽多平面狭窄的OSAHS患者50例,全麻下行改良悬雍垂腭咽成形术、鼻腔扩容术和/或鼻咽部腺样体切除术。测量术前清醒坐位,术前全麻卧位,术后全麻卧位,术后第1、2、3 d清醒坐位的咽腔间距,并记录术后当晚最低血氧饱和度和平均血氧饱和度,观察有无并发症。 结果　术后第1、2、3 d坐位时咽腔各间距测量值均大于术前坐位值,软腭长度小于术前。全麻术前卧位咽腔间距小于清醒坐位。全麻术后卧位咽腔间距大于全麻术前卧位。术后当晚平均血氧和最低血氧饱和度均高于术前。术后无呼吸困难、无术区出血,未行气管切开术。 结论　OSAHS鼻、咽部多平面联合手术术后气道得到明显扩张,未出现急性梗阻及渐进性狭窄所致呼吸困难。在严格把握适应症及密切监护的前提下可不行气管切开术。     

OSAHS患者腭咽组织血管内皮生长因子水平与微血管密度相关性分析

目的 探讨阻塞性睡眠呼吸暂停低通气综合征(OSAHS)患者腭咽组织中血管内皮生长因子(VEGF)水平与微血管密度(MVD)的相关性.方法 选择经多导睡眠监测仪(PSG)确诊的40例OSAHS患者组织标本(其中轻度7例,中度12例,重度21例),其中男性36例,女性4例;年龄29～62岁.6例无鼾症患者的软腭组织作为对照组,其中男性5例,女性1例;年龄18-58岁.采用苏木精-伊红(HE)染色法染色腭咽部组织,用光学显微镜观察其病理组织学改变,酶联免疫吸附分析检测血浆、腭咽组织匀浆中VEGF的含量,免疫组织化学技术检测MVD的表达情况.结果 酶联免疫吸附分析显示,OSAHS患者血浆及腭咽组织匀浆中VEGF水平均明显高于对照组,差异有显著统计学意义(P＜0.01);中、重度OSA HS组与对照组比较,MVD表达差异均有显著统计学意义(P＜0.01),轻度组与对照组比较差异无统计学意义(P＞0.05);组织匀浆中VEGF水平与MVD呈正相关(P＜0.01).结论 OSAHS患者腭咽部存在新生血管生成,与缺氧程度有关,VEGF在其发生发展过程中可能起到重要作用.     

合并及不合并阻塞性睡眠呼吸暂停脑卒中患者的咽部MRI分析

目的　通过对脑卒中阻塞性睡眠呼吸暂停（Obstructive Sleep Apnea，OSA）患者与非OSA患者咽部形态进行比较，了解咽部形态与脑卒中OSA的关系。 方法　发病30 d内的脑卒中患者入院后夜间行多导睡眠图监测后分为脑卒中OSA组及脑卒中非OSA组，两组患者均行咽部MRI检查并测得腭后距离、舌后距离、软腭长度、舌长、咽侧壁软组织的厚度、高口咽区面积、低口咽区面积、咽部最小面积等相关数值，将两组患者咽部测得相关值进行比较，将腭后距离与其他口咽测量指标、AHI、洼田饮水试验分级、年龄、病程、BMI、颈围行Pearson相关分析，并将腭后距离作脑卒中OSA患者受试者工作特征曲线 (Receiver Operating Characteristic Curve，ROC曲线)分析。 结果　脑卒中OSA组患者腭后距离较非OSA患者的偏小（P=0.002），脑卒中OSA患者腭后距离与舌后距离呈相关（R=0.502, P=0.017）；脑卒中OSA患者洼田饮水试验分级较非OSA患者偏高（P=0.049）；脑卒中OSA患者腭后距离与AHI值呈负相关（R=-0.873, P=0.000），腭后距离对脑卒中OSA的ROC曲线下面积为0.888，腭后距离对于脑卒中OSA有中等程度的诊断价值。 结论　咽部形态学改变与脑卒中OSA相关，腭后距离对脑卒中OSA有一定的诊断价值，腭后距离与脑卒中OSA严重程度有关；脑卒中OSA患者的洼田饮水分级较非OSA患者高，脑卒中患者OSA可能与吞咽障碍有关。     

Morphologic analyses of mandible and upper airway soft tissue by MRI of patients with obstructive sleep apnea hypopnea syndrome

STUDY OBJECTIVES: To evaluate the morphological features of the mandible and the volume of the upper airway soft tissues in determining the anatomical risk factors for the upper airway in Japanese male patients with obstructive sleep apnea hypopnea syndrome (OSAHS). METHODS: Five morphological parameters of the mandible at the mandibular base plane and three volumetric parameters of the upper airway soft tissue were analyzed using three-dimensional (3D) magnetic resonance imaging software in 31 OSAHS and 20 controls. RESULTS: There were no significant differences between the two groups in mandibular internal width (the distance between the internal right and left gonia [IRG and ILG]) and mandibular bony thickness. However, the patients with OSAHS had a significantly wider mandibular divergence (the angle between the spina mentalis (SM)- IRG line and SM- ILG line), a smaller mandibular internal length (the perpendicular distance from SM to the RG- LG line), and a smaller area than the normal subjects at the mandibular base plane. There were no significant differences in these morphological parameters for the mandible between obese and nonobese OSAHS patients. The volumes of the tongue, soft palate, and lateral pharyngeal walls were not significantly different between the OSAHS and the control groups. CONCLUSIONS: Japanese male OSAHS patients had specific anatomical features in the bottom part of the mandible; however, obesity seemed to be a less significant risk factor. Investigators and clinicians must realize that ethnicity may modify the effects of obesity and abnormal craniofacial anatomy as risk factors for the pathogenesis of OSAHS.     

典型男性OSAHS患者上气道气流运动特性的数值模拟

目的 研究典型男性阻塞性睡眠呼吸暂停低通气综合症（OSAHS）患者在平静呼吸时上气道气流运动特性,以及气流对软腭和悬雍垂作用的动力特点。方法 基于患者CT影像数据建立可靠的上气道流场几何模型,以临床睡眠监测数据作为数值模拟边界条件的依据,采用低雷诺数的湍流模型计算获得一个完整呼吸周期内上气道气流运动规律。结果OSAHS患者在呼吸过程中,上气道气流流动形式有显著差异。在吸气阶段,上气道腔内流速可达9.808 m/s,最大负压可达-78.856 Pa,鼻腔顶部出现局部回流,软腭受到的最大气流压力为-10.884 Pa,悬雍垂受到的最大气流压力为-51.946 Pa,气流对软腭和悬雍垂造成的最大剪切应力分别为78和311 mPa。在呼气阶段,上气道腔内最大流速为10.330 m/s,最大负压为-51.921 Pa,口咽部和鼻腔顶部均出现局部回流,且口咽部顺时针回流现象显著,软腭受到的最大气流压力为2.603 Pa,悬雍垂受到的最大气流压力为-18.222 Pa,软腭和悬雍垂受到的最大剪切应力分别为51和508 mPa。结论 口咽部是易塌陷的部位,一个呼吸循环过程的数值模拟可以捕捉到上气道流场显著的回流特征,上气道回流直接影响软腭和悬雍垂所受的力,同时也关系到患者呼吸的流畅程度。     

Surface tension of upper airway mucosal lining liquid in obstructive sleep apnea/hypopnea syndrome

STUDY OBJECTIVES: The obstructive sleep apnea hypopnea syndrome (OSAHS) is a disorder characterized by repetitive closure and reopening of the upper airway during sleep. Upper airway luminal patency is influenced by the surface tension (gamma) acting within the liquid layer lining the upper airway. The aim of the present study was to examine the gamma of upper airway mucosal lining liquid (UAL) in both healthy subjects and patients with OSAHS before and after sleep. DESIGN: Measurements were performed before (PM) and after (AM) an overnight polysomnographic study. SETTING: Sleep laboratory. PARTICIPANTS: We studied 11 healthy adults (5 men, 6 women) and 15 patients with OSAHS (14 men, 1 woman). INTERVENTIONS: None. MEASUREMENTS AND RESULTS: The gamma of UAL ("pull-off' force technique, pooled PM and AM samples) in patients with OSAHS was increased (59.9 [53.8, 58.8] mN/m; mean [95% confidence interval]) compared with healthy subjects (56.3 [57.7, 62.1] mN/m; linear mixed effects models; P =.05). In both groups there was no significant difference between PM (56.6 [53.7, 59.5] mN/m for healthy subjects, 60.1 [57.9, 62.3] mN/m for the patients with OSAHS) and AM (56.1 [51.8, 60.4] mN/m and 59.6 [57.4, 61.8] mN/m, respectively) samples for gamma of UAL and salivary flow rate (5 minutes unstimulated collection; PM =0.53 [0.22, 0.84] mL/minute for healthy subjects, 0.38 [0.22, 0.54] mL/minute for OSAHS; AM=0.39 [0.23, 0.55] mL/minute and 0.32 [0.2, 0.44] mL/minute). However, the occurrence of nasal breathing during sleep was associated with a fall in gamma of UAL overnight (r2 = 0.15, P < .05). CONCLUSION: Patients with OSAHS have normal salivary flow rate but an increased gamma of UAL. In both healthy subjects and OSAHS patients, nasal breathing during sleep was associated with an overnight fall in the gamma of UAL.     

鼻腔结构矫正手术对OSAHS患者上气道流场影响的数值分析

目的研究伴鼻腔结构异常的OSAHS患者经鼻腔结构矫正手术后,气道结构形态的改变对患者整个上气道流场分布以及软腭运动姿态的影响。方法基于患者手术前后CT影像学数据,建立上气道及软腭三维有限元模型,采用流固耦合的方法模拟手术前后上气道流场特性及软腭的运动情况。结果手术矫正了异常的鼻腔结构形态,鼻腔及整个上气道阻力明显下降。术后软腭的肥厚水肿明显缓解,其游离缘的运动幅度减小。软腭运动幅度随弹性模量的减小而增大。术后的模拟结果与文献报道的正常人实验与模拟结果接近。结论鼻腔结构矫正手术改变了上气道结构,影响了气流流场的分布和软腭的运动姿态;不同病理生理状态下,软腭弹性模量的变化对其运动姿态有影响。     

A novel volumetric magnetic resonance imaging paradigm to study upper airway anatomy

STUDY OBJECTIVES: We utilized novel three-dimensional volumetric analysis techniques with magnetic resonance imaging (MRI) to study the upper airway and surrounding soft-tissue structures. These MRI techniques allowed us to objectively quantify the volume of the tongue, soft palate, parapharyngeal fat pads, and lateral pharyngeal walls. DESIGN: We first validated our volumetric imaging techniques on a phantom and then demonstrated that our results were reliable and reproducible in normal subjects who did not lose weight. Finally, we studied 12 obese, nonapneic women during wakefulness before and after weight loss. We hypothesized that our novel magnetic-resonance computer-reconstruction techniques would allow us to detect small reductions in the volume of the tongue, soft palate, lateral pharyngeal walls, and parapharyngeal fat pads and increases in the volume of the upper airway with weight loss. SETTING: University medical center. PARTICIPANTS: Normal controls and 12 obese nonapneic women. INTERVENTIONS: Weight loss. MEASUREMENTS AND RESULTS: Following a mean 17.1+/-8.62 kg (17.3%) reduction in weight, upper airway volume increased (p = 0.06) in both the retropalatal and retroglossal regions. This increase in upper airway volume was mediated by significant reductions in the volume of the lateral pharyngeal wall (p = 0.0001) and parapharyngeal fat pads (p = 0.001). However, the volume of the tongue (p = 0.35) and soft palate (p = 0.39) were not reduced significantly with weight loss. CONCLUSIONS: These data indicate that volumetric MRI is a powerful tool to study anatomic changes in the upper airway and surrounding soft-tissue structures and is sensitive enough to detect changes in these structures.     

Breathing pauses during sleep: can a non-invasive ENT examination help identify subjects at risk in epidemiological settings?

In patients with obstructive sleep apnoea (OSA) anatomic and functional upper airway abnormalities are frequent and severe. Invasive methods are used to identify and quantitate the obstruction, to precisely locate its site, etc. as part of pre-treatment or of preoperative evaluations.These methods (lateral skull radiographs, computerized tomography, MRI, fibroscopies, etc) are too expensive and too invasive to be utilized in field surveys. To the classical sleep questionnaires and anthropometric measurements, some simple nose-throat examinations, easily accepted by the volunteers in a population study, could add useful information for the identification of the subjects at risk for sleep-disordered breathing. The present paper is a review of these examinations and of their utility.     

Tongue protrusion strength and fatiguability: relationship to apnoea/hypopnoea index and age

The sleep apnoea/hypopnoea syndrome (SAHS) is characterized by retroglossal or retropalatal narrowing. The site of obstruction, and the fact that negative pressure in the upper airway increases retroglossal airway size, suggests that tongue muscles may play a role in the maintenance of upper airway patency. We therefore hypothesized that tongue protrusion strength and fatiguability may be predictors of apnoea/hypopnoea index, vary with age and may be different in SAHS patients and normal subjects. Maximal strength (Fmax) and fatiguability (measured as the total time subjects were able to maintain 50% Fmax on three consecutive occasions separated by 30 s) were assessed using a force transducer in 98 consecutive apnoeic/hypopnoeic male patients referred to our laboratory for sleep studies [apnoea/hypopnoea index (AHI) range 3-130/h, age range 30-74 y]. Fmax and fatiguability were also compared in 15 male SAHS patients (mean AHI 20/h) and 15 nonsnoring male subjects matched for age, body mass index and fat free mass. A further 26 SAHS patients had tongue protrusion strength/fatiguability measured before, during and after a night's sleep. Log AHI was only weakly correlated with Fmax (r=- 0.21; P=0.03) and age (r=0.23; P=0.025), but not to fatiguability (P > 0.05). Comparison between SAHS and nonsnoring subjects did not demonstrate significant differences in Fmax (P=0.1) or fatiguability (P=0.1). There was no evidence of a change in muscle strength (P > 0.05) or fatigue (P > 0.05) during the course of a night's sleep. We conclude that tongue protrusion strength and fatiguability are unlikely to be important factors in the pathogenesis of SAHS.     

Early orthodontic treatment of skeletal Class II malocclusion may be effective to prevent the potential for OSAHS and snoring

OSAHS or snoring is an important condition within our community with the potential of being a significant health burden. Although the precise pathogenesis of upper airway obstruction during sleep remains uncertain in OSAHS and snoring patients, craniofacial risk factors are said to be associated with OSAHS and snoring. Since a high number of OSAHS and snoring patients consist of skeletal Class II malocclusion patients characterized by deficient mandible, then we can make the hypotheses that early orthodontic treatment of skeletal Class II malocclusion patients to improve such discrepancies during the growth period may be effective to prevent the potential for OSAHS and snoring.     

阻塞性睡眠呼吸暂停低通气综合征患者气道及下颌骨三维解剖特点与麻醉气管插管

目的　评估阻塞性睡眠呼吸暂停低通气综合征（Obstructive sleep apnea hypopnea syndrome，OSAHS）患者气道及下颌骨三维解剖特点与麻醉气管插管方式和次数。 方法　收集2014年到2019年期间于我院行全麻手术且已行头颈部螺旋CT扫描的正常气道及OSAHS气道患者各30例，使用Dolphin软件对患者的气道进行三维重建及气道分析，对患者的下颌骨进行三维重建及测量。同时，记录患者麻醉气管插管的方式和次数。 结果　OSAHS患者气道的气道体积、气道的矢状向、水平向和冠状向最小横截面积均较正常患者偏低，差异具有统计学意义（P<0.05）。OSAHS患者的下颌距离较正常患者偏低，差异具有统计学意义（P<0.05）；下颌角角度与正常患者相比，差异无统计学意义（P>0.05）。OSAHS患者麻醉插管的方式和次数与正常患者相比，差异具有统计学意义（P<0.05）。 结论　OSAHS患者气道及下颌骨三维解剖特点存在明显差异，利用气道和下颌骨的解剖学特点进行分析，可为临床全麻前气道评估和气管插管提供参考依据。     

阻塞性睡眠呼吸暂停低通气综合征患者气道及下颌骨三维解剖特点与麻醉气管插管

目的　评估阻塞性睡眠呼吸暂停低通气综合征（Obstructive sleep apnea hypopnea syndrome,OSAHS）患者气道及下颌骨三维解剖特点与麻醉气管插管方式和次数。 方法　收集2014年到2019年期间于我院行全麻手术且已行头颈部螺旋CT扫描的正常气道及OSAHS气道患者各30例,使用Dolphin软件对患者的气道进行三维重建及气道分析,对患者的下颌骨进行三维重建及测量。同时,记录患者麻醉气管插管的方式和次数。 结果　OSAHS患者气道的气道体积、气道的矢状向、水平向和冠状向最小横截面积均较正常患者偏低,差异具有统计学意义（P<0.05）。OSAHS患者的下颌距离较正常患者偏低,差异具有统计学意义（P<0.05）;下颌角角度与正常患者相比,差异无统计学意义（P>0.05）。OSAHS患者麻醉插管的方式和次数与正常患者相比,差异具有统计学意义（P<0.05）。 结论　OSAHS患者气道及下颌骨三维解剖特点存在明显差异,利用气道和下颌骨的解剖学特点进行分析,可为临床全麻前气道评估和气管插管提供参考依据。