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目的:通过比较CT片上阻塞性睡眠呼吸暂停低通气综合征(OSAHS)患者及正常成人鼻咽腔的大小及硬腭长度,探讨其对OSAHS发病及严重性的影响,为选择合适的手术方式奠定基础。方法:选经PSG确诊的OSAHS患者39例,健康成人30例,行鼻咽顶至声门的CT连续扫描并刻录成光盘输入计算机,用Efilm软件对图像进行矢状位三维重建,选取鼻咽正中线即硬腭最长层面,测量各项参数,对数据行统计学处理并分析临床意义。结果:OSAHS患者上牙槽座点-后鼻棘距(A-PNS)明显大于对照组(P<0.05),后鼻棘-鼻咽顶点距(PNS-R)明显小于对照组(P<0.05),硬腭后间隙(PNS-B)明显小于对照组(P<0.01);以30例正常人测量资料95%可信区间为正常值标准,在39例OSAHS患者中6例A-PNS大于正常值上限,10例PNS-R小于正常值下限,16例PNS-B小于正常值下限,其中有2例患者同时存在A-PNS大于正常值上限及PNS-R小于正常值下限,5例患者同时存在PNS-R及PNS-B小于正常值下限,1例患者同时存在A-PNS大于正常值上限及PNS-B小于正常值下限;在39例OSAHS患者中,鼻咽腔小、硬腭长的24例患者的AHI明显大于鼻咽腔不小、硬腭不长的15例患者,SaO2明显小于后者。结论:OSAHS患者与正常人比较,鼻咽腔明显狭窄,硬腭明显较长,提示虽然OSAHS患者上气道狭窄主要在口咽部,但鼻咽腔大小及硬腭长度对OSAHS的发病及严重性均有影响,故手术方式的选择应充分考虑该因素。
OBJECTIVE: To compare the size of the nasopharyngeal cavity and the length of the palate in patients with obstructive sleep apnea-hypopnea syndrome (OSAHS) and normal adults with chronic obstructive sleep apnea-hypopnea syndrome (OSAHS), and to explore its effect on the pathogenesis and severity of OSAHS and to lay the foundation for the selection of suitable surgical methods . Methods: Thirty-nine patients with OSAHS diagnosed by PSG and 30 healthy adults were enrolled in this study. CT scan of nasal pharyngeal glottipus to glottis was performed and recorded on a computer. The images were then reconstructed by Efilm software. The nasopharyngeal The midline, the longest palate of the hard palate, measures various parameters and performs statistical processing on the data and analyzes the clinical significance. Results: A-PNS was significantly larger in OSAHS patients than in control group (P <0.05), PNS-R was significantly lower in OSAHS patients than in controls (P <0.05) ), PNS-B was significantly lower than that of the control group (P <0.01). The 95% confidence interval of 30 normal subjects was normal, and in 39 patients with OSAHS, A-PNS was larger than normal PNS-R in 10 cases was less than the lower limit of normal, and PNS-B in 16 cases was less than the lower limit of normal. There were 2 patients with A-PNS greater than the upper limit of normal and PNS-R less than the lower limit of normal. There was PNS-R and PNS-B less than the lower limit of normal, 1 patient with A-PNS greater than the upper limit of normal and PNS-B less than the lower limit of normal; in 39 patients with OSAHS, the nasopharyngeal small, long palate 24 The AHI of patients was significantly greater than the nasopharyngeal cavity is not small, the hard palate is not long in 15 patients, SaO2 was significantly less than the latter. Conclusion: Compared with normal subjects, OSAHS patients have obvious stenosis of the nasopharyngeal cavity and obvious long palatal palate, which indicates that although the upper airway stenosis in OSAHS is mainly in the oropharynx, the size and length of the nasopharynx affect the incidence and severity of OSAHS Affect, so the choice of surgical approach should give full consideration to this factor.