阻塞性睡眠呼吸暂停综合征上气道阻塞CT定位研究

目的 应用多层螺旋CT扫描研究阻塞性睡眠呼吸暂停综合征(OSAS)患者在清醒及睡眠期不同呼吸时相的上气道阻塞情况，并探讨该方法在OSAS患者术前定位诊断中的应用价值。方法 20例OSAS患者，在呼气末二氧化碳仪的监控下，对其清醒及睡眠呼吸暂停期的上气道进行多层螺旋CT扫描检查。18例同龄正常成年人作为对照组。结果 OSAS患者上气道截面积较正常者狭小，并以腭咽及舌咽平面为主。此差别在睡眠呼吸暂停期表现得比清醒期更为显著，尤以舌咽部明显。所有患者在腭咽平面都存在阻塞性病变，其中65％的患者同时合并有舌咽平面的阻塞性病变。结论 该方法能反映OSAS患者上气道生理及病理状态下的阻塞情况，从而提供更为准确的定位诊断信息，对OSAS患者治疗方案的选择、手术疗效的预估具有重要意义。

Study of Upper Airway Obstruction Sites in Patients with Obstructive Sleep Apnea Syndrome

Objective To evaluate the upper airway of patients with obstructive sleep apnea syndrome (OSAS) while they were awake, asleep and apneic by means of multislice CT scan and analyse its value in pre - operative topodiagnosis. Methods Twenty patients with OSAS underwent multislice CT scan while awake and during sleep apnea episodes under monitoring of capnography, 18 age - matched normal subjects were selected as the control group. Results The pharyngeal cross - sectional area of OSAS patients was smaller than that of normal subjects, mainly at the velopharynx and tongue - pharynx. This difference became greater when patients were asleep and apneic, particularly at the tongue - pharynx. All patients had obstructive changes at the velopharynx and 65% of them had both velopharynx and tongue -pharynx airway abnormalities. Conclusion This method may show the obstructive lesions in the anatomic and physiologic state and provide more accurate information of localizing the upper airway obstruction sites in patients with OSAS. The results can be used for selection of appropriate therapy and prediction of surgical outcome.