三维CT重建在肥胖OSAHS患者与正常人群上气道比较中的应用

目的 通过三维CT(3D-CT) 重建技术,分析肥胖阻塞性睡眠呼吸暂停低通气综合征（OSAHS）患者与正常成人上气道的差异,并用于困难气道的预测。方法 选择肥胖OSAHS患者及正常成人对照各31例,肥胖OSAHS患者美国麻醉师协会（ASA）分级Ⅱ级,年龄（34.33±10.07）岁（17~55岁）,BMI为（39.05±5.17）kg/m²。对照组ASA分级Ⅰ~Ⅱ级,年龄（28.34±6.41）岁（18~35岁）,BMI为（23.23±4.51）kg/m²。采用Mimics 11.04软件,分别对2组对象的上气道三维CT重建数据进行测量分析,得到包括气道最小横截面、气道体积等数据,比较困难气道患者与正常人咽气道三维形态的差异,采用SPSS 21.0软件包对数据进行统计学分析,评价困难气道患者上气道三维CT形态特征。结果 困难气道患者上气道总体积、软腭后区体积及会厌后区体积与正常对照组相比均显著减小（P<0.05）,舌后区体积与正常对照组无显著差异（P>0.05）。结论 3D-CT重建测量可以明确上气道狭窄部位、严重程度,可作为较好的困难气道术前评估量化手段。

Application of 3D-CT reconstruction in comparison of upper airway between obese patients with obstructive sleep apnea-hypopnea syndrome and normal persons

PURPOSE: To evaluate the upper airway condition more precisely by using three-dimensional CT reconstruction (3D-CT) in patients with difficult airway during preoperative assessment. METHODS: A total of 62 obese patients with obstructive sleep apnea-hypopnea syndrome (OSAHS) and normal adults were recruited. ASA grade Ⅱ of obese OSAHS patients was 34. 33± 10. 07 (17-55) years old, with a BMI of (39. 05±
5. 17)kg/m². In the control group, ASA grade Ⅰ to Ⅱ was 28. 34±6. 41 (18-35) years old, and the BMI was (23. 23±
4. 51)kg/m². Mimics 11. 04 was used to analyze the upper airway of OSAHS patients and normal people by reviewing the upper airway 3D-CT data which included the minimum area and the volume of the upper airway. Difference of the upper airway between OSAHS patients and normal ones in 3D-CT reconstruction was analyzed with SPSS 21. 0 software package. RESULTS: OSAHS patients' volume of total airway, retropalatal region and epiglottal region were significantly smaller than the controls (P< 0. 05). There was no significant difference in retroglossal region between OSAHS patients and the controls(P> 0. 05). CONCLUSIONS: 3D-CT reconstruction can display upper airway stenosis and is a good preoperative assessment of difficult airway.