【摘要】 目的　改进既往Muller动作的纤维鼻咽喉镜检查和常规的多导睡眠描记( polysomnography ,PSG)监测 ,观察药物诱导睡眠下纤维鼻咽喉镜和PSG监测的所见 ,探讨同步检查的可行性。方法　前瞻性自身对比研究。药物诱导睡眠下的纤维鼻咽喉镜检查和PSG监测 ,之前或之后予常规的纤维鼻咽喉镜检查和PSG监测 ,观察两者检测结果的差别。结果　 32例阻塞性睡眠呼吸暂停低通气综合征 (obstructivesleepapneahypopneasyndrom ,OSAHS)患者中 ,鼻咽狭窄 17例 ,均伴有口咽狭窄 ;鼻咽、口咽伴有喉咽狭窄 8例 ;2例为口咽狭窄 ,伴扁桃体肥大 ,5例为喉咽狭窄。其中悬雍垂腭咽成形术后 3例中 ,2例为喉咽狭窄 ,1例为鼻咽狭窄。药物诱导睡眠下的PSG监测与常规PSG监测结果明显相关。但异常程度高于常规的检查。药物睡眠呼吸暂停指数的下降同步于咽部的阻塞 ,但恢复迟于咽部的阻塞。三部位均狭窄的睡眠呼吸暂停低通气指数 (apnea hypopneaindex ,AHI)改变最为严重 ,鼻咽并口咽次之 ,再次为单独的喉咽或口咽狭窄。结论　药物诱导睡眠下的纤维喉镜和PSG监测可以清楚的显示鼻咽、软腭、舌根在鼾声和OSAHS中的动态变化 ,在观察鼻咽、口咽阻塞的同时 ,同步记录到OSAHS的存在及程度 ,为从形态学和机能学的角度深入分析鼾声和OSAHS提供了可更多还原

【Abstract】 Objective Improve the nasopharyngoscop of Muller′s maneuver and overnight polysomnograghy (PSG) Analyze the findings of nasopharyngoscop and PSG during sleep Probe into the possibility of sychronized examinations Methods Prospective case control study of ramdomized sampling Description of the nasendoscopy and PSG during drug induced sleep after or before overnight nasendoscopy and PSG Comparison of the findings Results Among thirty two patients included, the narrowing sites for 17 patients are in velopharynx which combined with the oropharynx narrowings, 8 in velopharynx with hypopharyngeal narrowings 2 in oropharynx 5 in hypopharyngnx 2 of three cases after uvulopalatopharyngoplasty are hypopharyngeal narrowings, one is still in the velopharynx The sleep PSG is obviously relative to overnight PSG, but its abnormal degree is higher The AHI decrease is in the same phase as pharynx obstruction, but returns a little later The first hightest AHI is seen among the patients with two sites of narrowings, while the second among those with velopharynx narrowings And the third with hypopharynx and oropharynx Conclusions The dynamatic change of velopharynx, soft plate, tongue base and PSG of patients who have snorings and OSAHS can be seen clearly in the examination of nasendoscopy and PSG during drug induced sleep The existence and grade of OSAHS can synchronously be recorded at same time as the velopharynx and oropharynx be observed This affords a possibility for deep analyses of snorings and OSAHS in the point of morphorlogic and functional view in laboratory更多还原