【摘要】 目的运用生物力学研究阻塞性睡眠呼吸暂停低通气综合征(OSAHS)患者不同阻塞平面对上气道气流场的影响。方法选取鼻腔、口咽以及鼻腔和口咽气道狭窄的重度OSAHS患者为病例1、病例2、病例3,建立上气道三维有限元模型,设定气流为600 ml,获取上气道气流场各代表截面呼气、吸气相压强、流速;分析不同阻塞平面对OSAHS患者上气道通气功能的影响。结果病例1、病例2、病例3鼻阈区压强降、鼻阻力及口咽截面压强变化具有一定特征:①鼻阈区压强降占鼻腔整体压强降百分比分别为25%、64%、33%,病例1、病例3明显小于病例2;②吸气相鼻阻力:分别为0.775、0.711、0.835 kPa·s/L;③腭后区至口咽部的压强降渐增大:腭后区压强分别为-46.5、-42.7、-50.1 Pa,口咽部压强分别为-209、-70、-261 Pa。结论 OSAHS患者上气道单一鼻腔或咽腔部位狭窄在影响局部通气功能的同时,上气道其他区域如鼻阈、鼻腔或咽腔通气功能也有减退。更多还原

【Abstract】 OBJECTIVE　Biomechanics was used to study the influence of different obstructive levels on upper airway airflow field in obstructive sleep apnea hypopnea syndrome(OSAHS) patients.METHODS　Severe OSAHSpatients with nasal,oropharyngeal,nasal and oropharyngeal level stenosis were selected as cases 1,2 and 3,a three-dimensional finite element model of the upper airway was established.The airflow velocity was set as 600 ml,and the exhaling and inhaling pressure,velocity of each representative section of the upper airway flow field were obtained.The effects of different obstructive levels on upper airway ventilation function in OSAHS patients were analyzed.RESULTS　The pressure drop in limen nasi area,nasal resistance and oropharyngeal section of cases 1,2 and 3 had certain characteristics:1.The percentages of pressure drop of limen nasi to the overall nasal pressure drop were 25%,64% and 33%,respectively,which were significantly lower in case 1 and 3 than in case 2;2.Nasalresistance in inspiratory phase:0.775,0.711,0.835 kPa·s/L,respectively;3.The pressure drop from retropalatal region to oropharynx gradually increased:the pressure of retropalatal region was-46.5,-42.7,-50.1 Pa,and the pressure of oropharynx was-209,-70,-261 Pa.CONCLUSION　Inpatients with OSAHS,the stenosis of the single nasal or pharyngeal cavity of the upper airway affects the local ventilation function,and at the same time,the ventilation function of other areas of the upper airway,such as the limen nasi area,nasal or pharyngeal cavity,also were decreased.更多还原