纤维喉镜与模拟内镜技术对阻塞性睡眠呼吸暂停低通气综合征的诊断价值

目的:比较纤维喉镜与模拟内镜技术在阻塞性睡眠呼吸暂停低通气综合征(OSAHS)诊断中的作用和各自的优缺点;进一步探讨上呼吸道在阻塞通气过程中的变化特点.方法:我们对21例经睡眠监测确诊为OSAHS的患者行电子纤维喉镜检查,并行螺旋CT扫描后经软件处理.获得仿真上呼吸道图像.检查在清醒和睡眠2种状态下进行.测量软腭平面、悬雍垂平面、舌后平面和会厌平面的前后径和左右径.结果:纤维喉镜与仿真上呼吸道图像在上呼吸道的4个平面的测量上均差异有统计学意义;在清醒和睡眠状态下,软腭后区前后径的变化差异无统计学意义,其左右径差异有统计学意义.结论:清醒与睡眠状态下,上呼吸道的腔径有明显不同;腔径的变化以左右径变化为主;纤维喉镜在上呼吸道的动态观察中有很重要的诊断价值;仿真上呼吸道图像能够真实的显示上呼吸道狭窄的部位和程度;结合原始的二维图像可提供解剖结构和病理变化的相关信息.

The evaluation of virtual endoscopy and fiberoptic endoscopy in the diagnosis of obstructive sleep apnea syndrome

Objective:The utility of virtual endoscopy is compared to fiberoptic endoscopy and was also investigated with respect to accuracy of diagnosis and reproduction of images in patients with obstructive sleep apnea hypopnea syndrome(OSAHS).Method:Twenty-one patients with OSAHS were examined by helical spiral CT axial images and fiberoptic endoscopy.The helical spiral CT axial data was reconstructed using a VE software program.The results were compared to the fiberoptic endoscopic findings done by the otolaryngologists.All the patients were examined both in the sleeping and nonsleeping status.The dimensions of soft palate,uvula,lingua and epiglottis region were evaluated.Result:The results both in the virtual endoscopy evaluation and fiberoptic endoscopy was statistically significant difference in all of region.In the palate region,there was statistically significant difference in the left-and-right dimension,but no difference in the fore-and-aft dimension both in the sleeping and nonsleeping status.Conclusion:The dimensions of upper airway were more difference between in the sleeping and nonsleeping status.The change of dimension was more in the left-and-right;the fiberoptic endoscopy has more diagnostic significance in evaluation of dynamic movement of the upper airway;virtual endoscopy evaluation of the upper airway was accurate in assessing stenosis width and length;virtual endoscopy added more information about anatomic structure and pathological change of the upper airway.