儿童腺样体肥大的直接数字化X线影像表现及临床应用价值

目的探讨儿童腺样体肥大的直接数字化X线影像表现及对儿童阻塞性睡眠呼吸暂停低通气综合征（OSAHS）的临床应用价值。方法选择120例鼾症儿童，采用直接数字化X线影像行鼻咽部侧位摄片，测量腺样体-鼻咽腔比值（A／N）．判断腺样体的大小；然后行多导睡眠图监测（PSG），比较OSAHS患儿和原发性鼾症患儿A／N的差异，分析其临床价值。结果120例鼾症儿童A／N分布于0.51～0.88。OSAHS患儿75例，A／N0.68～0．88（0．79±0.06）；原发性鼾症患儿45例，A／N0.51～0．69（0.57±0．05），OSAHS患儿A／N显著高于原发性鼾症患儿（P〈0.01）；OSAHS患儿中0．60≤A／N〈0．70 5例，A／N≥0.70 70例，原发性鼾症患儿A／N〈0．60 28例，0．60≤A／N〈0．70 17例，OSAHS患儿A／N≥0.70的比例显著高于原发性鼾症患儿（P〈0．01）。结论直接数字化X线影像测量儿童A／N简便、实用，能直观清晰显示腺样体的形态和大小，以及鼻咽腔的宽度和肥大的腺样体阻塞鼻咽腔造成上气道狭窄的程度；A／N对于儿童OSAHS的诊断及治疗具有重要的指导意义。

Clinical application of direct digital radiography in children with adenoid hypertrophy

Objective To evaluate the clinical application of direct digital radiography in children with adenoid hypertrophy and obstructive sleep apnea hypopnea syndrome （OSAHS）. Methods One hundred and twenty cases of snoring children were recruited. Lateral radiographs on nasopharynx were taken by direct digital radiography and the sizes of adenoid tonsil were estimated by adenoid-nasopharynx ratio （A/N）. Based on the diagnosis by polysomnogram （PSG）, 120 snoring children were divided into group of OSAHS and group of primary snoring. The adenoid-nasopharynx ratio （A/N） and distributiin were compared between two groups. Results The adenoid-nasopharynx ratio in 75 OSAHS patients was 0.79 ±0.06 （0.68- 0.88）, while that of primary snoring sufferers was 0.57±0.05 （ 0.51 - 0.69） （P〈0.01）, The incidence of A/N over 0.7 in group of OSAHS was significantly higher than that in group of primary snoring （P〈0.01）. Conclusion Direct digital radiography is a practical to measure the A/N ratios in children with adenoid hypertrophy and to diagnose of OSAHS in children.