性别、年龄及肥胖与阻塞性睡眠呼吸暂停低通气综合征相关分析

目的:研究阻塞性睡眠呼吸暂停低通气综合征(OSAHS)患者发病的危险因素。方法:回顾分析进行睡眠监测的189诊断为OSAHS的患者,总结探讨性别、年龄和肥胖对OSAHS发病的影响。结果:OSAHS男性发病率较女性高;30～50岁之间患者发病率较高;体重指数(BMI)>30kg/m2患者所占比例不大。结论:男性和中年是OSAHS发病的危险因素,除了肥胖,对于中国人来讲,颌面骨畸形亦是导致OSAHS发生的重要因素。     

喉癌组织LC3转录水平的表达及其意义

目的:探讨喉癌中微管相关蛋白1轻链3(LC3)mRNA的表达及其意义.方法:RT-PCR法检测41例喉癌组织,癌旁组织及11例声带息肉组织中LC3 mRNA的表达.结果:喉癌组织中LC3 mRNA表达量明显低于癌旁及声带息肉组织,差异有统计学意义(P＜0.01).结论:LC3基因的表达水平下调与喉癌的发生密切相关,可能...     

影像导航技术在鼻腔鼻窦内翻性乳头状瘤手术中的应用

目的 探讨影像导航技术在鼻腔鼻窦内翻性乳头状瘤(NIP)手术中的应用价值 。方法 将68例行手术治疗NIP患者按时间顺序分为前、后两组,前组应用鼻内镜手术或鼻内镜手术+传统术式（2001年5月～2004年12月）34例,后组以前组术式为基础加用影像导航技术（2005年1月～2007年6月）34例,对两组术后复发率进行比较。结果 应用影像导航技术的后组术后复发率低于前组,差异有统计学意义（P＜0.05）。 结论影像导航技术在鼻腔鼻窦内翻性乳头状瘤手术中能进行三维重建,具有定位准确、影像立体,不受组织移位和解剖复杂影响的优点,可降低术后的复发率。     

鼻部手术联合其他平面手术治疗OSAHS疗效分析

目的探讨鼻部手术联合其他平面手术（如腭咽平面、舌咽平面手术）治疗阻塞性睡眠呼吸暂停低通气综合征（ｏｂｓｔｒｕｃｔｉｖｅ ｓｌｅｅｐ ａｐｎｅａ ｈｙｐｏｐｎｅａ ｓｙｎｄｒｏｍｅ,ＯＳＡＨＳ）的效果。方法32例患者术前均行多导睡眠呼吸监测（ｐｏｌｙｓｏｍｏｎｏｇｒａｐｈｙ,ＰＳＧ）确诊,所行鼻部手术包括单纯鼻中隔偏曲黏膜下切除术１８例、鼻中隔偏曲黏膜下切除术加单侧下鼻甲黏膜下部分切除术10例、鼻中隔偏曲黏膜下切除术加双侧下鼻甲黏膜下部分切除术2例、鼻中隔偏曲黏膜下切除术加单侧鼻息肉切除加筛窦开放术2例。术中同期联合悬雍垂腭咽成形术（ｕｖｕｌｏｐａｌａｔｏｐｈａｒｙｎｇｏｐｌａｓｔｙ,ＵＰＰＰ）26例;UPPP手术、舌根部分切除、舌骨悬吊4例;舌根部分切除、舌骨悬吊2例。32例中2例重度患者行气管切开全麻下行ＵＰＰＰ和鼻部手术、舌根部分切除术,２例因为气管插管和拔除气管套管困难,在手术结束后行气管切开,余28例均在气管插管全麻下进行手术,术后进ICU监护12～24h,随访１年。结果治愈10例,好转12例,减轻9例,无效1例,所有患者无手术并发症发生。结论鼻部手术联合其他平面手术治疗ＯＳＡＨＳ可取得良好效果。对于重度ＯＳＡＨＳ或气管插管困难者,术前行气管切开术或手术结束即行气管切开,能有效预防手术并发症的发生。     

Performance characteristics of fluorescence endoscope in detection of head and neck cancers

Laser-induced fluorescence endoscopy (LIFE) is a noninvasive method for detecting early cancers in hollow organs. A laser-induced fluorescence endoscope that was designed for lung imaging was investigated for its effectiveness in comparison to white light endoscopy (WLE) in localizing head and neck cancers. A total of 196 images from 98 sites in 56 patients were graded into 5 levels from normal to definitely abnormal. A cutoff level to differentiate normal from abnormal images was chosen from a receiver operating characteristic curve. On this basis, LIFE (sensitivity, 92.86%; specificity, 78.57%) was observed to be more effective and reliable than WLE (sensitivity, 67.86%; specificity, 70%) in locating neoplastic foci and precancerous lesions. Nevertheless, WLE was helpful in presenting anatomic details. The reliability of LIFE varied from site to site. It excelled in examination of the oropharynx (sensitivity, 100%; specificity, 96.20%), but was less effective for lesions of the nasopharynx (sensitivity, 66.70%; specificity, 75.00%). In standardizing the test, interobserver variation was assessed, and good agreement in image interpretation was confirmed by statistical analysis. In conclusion, LIFE was found to be an effective and reliable tool for detecting head and neck cancers.