定位X射线侧位头颅片在诊断儿童阻塞性睡眠呼吸暂停低通气综合征中的价值

目的采用定位X射线侧位头颅片的检查技术,观察儿童阻塞性睡眠呼吸暂停低通气综合征的腺样体肥大及颅骨测量,评估该方法在评估腺样体肥大及对上颌骨及下颌骨发育影响的价值。方法选择2006年至2010年在河北医科大学第一医院治疗的腺样体肥大患儿65例,其中男性31例,女性34例;年龄6岁1个月～7岁4个月,平均年龄7.10岁。并发分泌性中耳炎12例,慢性鼻-鼻窦炎20例,明显发育迟缓13例。在定位X射线侧位头颅片上把腺样体肥大程度分为Ⅰ组(n=35)A/N≥0.76,Ⅱ组(n=30)A/N≤0.75;以病程的长短分为A组(n=41)病程在3年以上(包括3年),B组(n=24)病程3年以下。回顾性分析比较两种情况下两组的颅骨测量值。结果腺样体的体积越大,对患儿面颅骨发育的影响越明显,Ⅰ、Ⅱ组的∠SNA(84.15°±1.76°vs 82.18°±2.11°;P<0.01)、∠SNB(78.91°±1.35°vs 77.92°±1.97°;P<0.05)和∠ANB(5.18°±1.09°vs 4.25°±0.95°;P<0.01)差异均有统计学意义。患病时间越长对患儿面颅骨发育的影响越重,A、B组的∠SNA(84.02°±1.73°vs 81.89°±2.17°;P<0.01)、∠SNB(78.92°±1.36°vs 77.65°±1.99°;P<0.01)和∠ANB(5.06°±1.06°vs4.23°±1.03°;P<0.01)差异均有显著统计学意义。结论定位X射线侧位头颅片可以很好地显示和测量腺样体;腺样体肥大可明显影响颅骨的发育;颅骨发育异常的严重程度与腺样体的体积和病程持续时间有关。

The value of location X-ray lateral skull film in diagnosis of pediatric obstructive sleep apnea syndrome

Objective To observe the adenoidal hypertrophy in pediatric obstructive sleep apnea syndrome by measurement of skull and location X-ray lateral skull film inspection technique,and assess its effect in adenoid hypertrophy and development of maxilla and mandible.Methods A total of 65 cases with adenoidal hypertrophy from 2006 to 2010 were enrolled,male 31,female 34,aged 6 years and 1 month-7 years and 4 months,mean age 7.10 years old.There were 12 cases complicated with effusion,20 cases of chronic nose-sinusitis and 13 cases of significant growth retardation.On the basis of adenoid hypertrophy degree,those cases were divided into groupⅠ(n = 35) A/N ≥ 0.76,and groupⅡ(n = 30) A/N ≤ 0.75;By the duration of disease,those cases were divided into group A(n = 41),course of disease upper 3 years(included 3 years) and group B(n = 24),course of disease under 3 years.The skull measurements of 2 cases in 2 groups were retrospective analyzed and compared.Results It was showed that the larger adenoid size,the greater affected on children craniofacial development.The ∠SNA(84.15° ± 1.76° vs 82.18° ± 2.11°;P < 0.01),∠SNB(78.91° ± 1.35° vs 77.92° ± 1.97°;P < 0.05),∠ANB(5.18° ± 1.09° vs 4.25° ± 0.95°;P < 0.01) of groupⅠ and Ⅱ were statistically significant differences.The longer the children sickened,the heavier the impact of craniofacial development,so there were statistically significant differences between group A and B on ∠SNA(84.02° ± 1.73° vs 81.89° ± 2.17°;P < 0.01),∠SNB(78.92° ± 1.35° vs 77.65° ± 1.99°;P < 0.01) and ∠ANB(5.06° ± 1.06° vs 4.23° ± 1.03°;P < 0.01).Conclusion It is demonstrated that the location X-ray lateral skull film could display and measure adenoids,and the adenoidal hypertrophy could significantly affect the development of skull.In addition,the skull abnormalities is associated with the severity of adenoid size and duration of the course.