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阻塞性睡眠呼吸暂停综合征患者睡眠状态下阻塞定位研究

Upper airway occlusion sites of obstructive sleep apnea

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【作者】 林忠辉张红蕾王廷础李传福白志学

【Author】 LIN Zhonghui *, ZHANG Honglei, WANG Tingchu, et al. *Department of Otolaryngology and Head Neck Surgery , Affiliated Beijing Tongren Hospital, The Capital Medical University, Beijing 100730,China Corresponding author:LIN Zhonghui (Email: bjsent@public3

【机构】 北京首都医科大学附属北京同仁医院耳鼻咽喉头颈外科山东医科大学卫生部耳鼻咽喉科重点实验室

【摘要】 目的 应用磁共振成像 (magneticresonanceimaging ,MRI)和纤维鼻咽喉镜对阻塞性睡眠呼吸暂停综合征 (obstructivesleepapneasyndrome,OSAS)患者睡眠状态下上气道的阻塞部位进行定位 ,并探讨上述两种方法对阻塞定位的应用价值。方法 对经多导睡眠监测 (polysomnography ,PSG)确诊的 15例OSAS患者应用超快速MRI在睡眠状态下对其上气道进行了矢状位和轴位扫描动态观察 ,对患者软腭后区 (retropalatalregion ,RP)、舌后区 (retroglossalregion ,RG)和会厌区 (epiglottalregion ,EPG)的上气道阻塞情况进行了观察分析。另外对其中的 8例患者在睡眠状态下进行了纤维鼻咽喉镜检查。结果 MRI检查 15例患者 ,发现仅有RP区阻塞者 3例 ,仅有RG区阻塞者 2例 (均为悬雍型腭咽成形术后患者 ) ,另外 10例患者同时有RP和RG区阻塞。 8例患者进行睡眠状态下纤维鼻咽喉镜检查者 ,除 1例外检查结果与MRI检查相符合。结论 睡眠状态下MRI和纤维鼻咽喉镜检查能够对上呼吸道的阻塞进行定位 ,对确定治疗措施具有一定指导意义。

【Abstract】 Objective To locate the obstruction sites in patients with obstructive sleep apnea syndrome (OSAS) during sleep by MRI imaging and dynamic fiberoptic pharyngoscopy. Methods Fifteen OSAS patients confirmed by polysomnography (PSG) underwent ultrafast MR imaging during sleep. Their sequential midline sagittal and axial images were obtained and displayed in the cine mode. Then we examined the upper airway of the retropalate region (RP), retroglottal region (RG) and epiglottal region (EPG). We also did dynamic fiberoptic pharyngoscopy examination during sleep in 8 patients in another night. Results Among the 15 patients, 3 had only RP region obstruction, 2 had only RG region obstruction, and the other 10 had both RP & RG airway obstruction. In the 8 cases monitored with both MRI and fiberoptic pharyngoscopy, the results obtained from the 2 methods were identical. Conclusion MRI and fiberoptic pharyngoscopy are useful in locating the pharyngeal airway obstruction sites of OSAS patients and would be helpful in selecting treatment measures.

  • 【文献出处】 中华耳鼻咽喉科杂志 ,CHINESE JOURNAL OF OTORHINOLARYNGOLOGY , 编辑部邮箱 ,2000年02期
  • 【分类号】R766
  • 【被引频次】40
  • 【下载频次】182
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