天津医药

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重度OSAHS患者手术前后鼻腔容积的变化

杨翠红1,林鹏2   

  1. 1. 天津市第一中心医院耳鼻咽喉头颈外科学
    2. 天津医科大学一中心临床学院
  • 收稿日期:2012-10-29 修回日期:2013-02-05 出版日期:2013-05-15 发布日期:2013-05-15
  • 通讯作者: 杨翠红

The Study of Pre- and Post-Operative Nasal VolumeChanges in Patients with Severe OSAHS

YANG CUI HONG1,LIN Peng 2   

  1. 1. The First Central Clinical College of Tianjin Medical University
    2. The First Center Clinic College, Tianjin Medical University
  • Received:2012-10-29 Revised:2013-02-05 Published:2013-05-15 Online:2013-05-15
  • Contact: YANG CUI HONG

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摘要：

【摘要】 目的 研究无鼻腔疾病的重度阻塞性睡眠呼吸暂停低通气综合征(OSAHS)患者手术前后鼻腔容积的差异。方法 102例健康成年人作为正常组;46例行等离子辅助改良悬雍垂腭咽成形术+舌体打孔消融术(H-UPPP+CCT)的仅腭咽合并舌咽平面阻塞的重度OSAHS患者作为观察组。利用鼻声反射仪测量观察组术前、术后6个月及正常组的单侧鼻腔0～5cm容积(V5)、2～5cm容积(V2～5)、鼻腔最小截面积(MCA)、最小截面积距前鼻孔的距离(DCAN);利用多导睡眠监测仪记录观察组术前、术后6个月的鼾声指数(SI)、呼吸暂停低通气指数(AHI)、最低血氧饱和度(LSaO2)、平均血氧饱和度(SaO2),并对检测结果进行统计分析。结果 观察组术前V5、V2～5均较正常组减小(P<0.01)。观察组术后V5、V2～5均较术前增大(P<0.05),与正常组比较差异无统计学意义(P>0.05);术后SI、AHI、LSaO2、SaO2均较术前改善(P<0.05)。结论 无鼻腔疾病的重度OSAHS患者鼻腔容积较正常人明显减小,手术改善上气道塌陷的同时亦能增大鼻腔容积,改善鼻通气。

关键词: 鼻测量, 声学, 睡眠呼吸暂停, 阻塞性, 多道睡眠描记术, 外科手术

Abstract: Objective   To investigate pre- and post-operative of nasal volume in severe OSAHS patients without nasal disease. Method  This study included 102 healthy volunteers as control group and 46 severe OSAHS patients without nasal disease as observation group, all patients were underwent coblation-assisting modified uvulopalatopharyngoplasty combined with coblation-channeling of tongue(H-UPPP & CCT). The nasal volume from 0 to 5cm,2 to 5cm(V5,V2-5),the minimum cross-sectional area(MCA) and the distance of the minimal cross-sectional area to the nostril(DCAN) were measured by Acoustic rhinometry(AR), while snoring index(SI), apnea-hypopnea index(AHI), the lowest oxygen saturation(LSaO2) and the average oxygen saturation(SaO2) were recorded by Polysomnography(PSG) before operation and 6 months after operation respectively. Result  Compared with normal group, the preoperative V5 and V2-5 decreased in observation group(P<0.01). V5 and V2-5 in observation group increased after operation(P<0.05), but with no significant difference compared with normal group. SI, AHI, LSaO2 and SaO2 were all improved in observation group post-operative(P<0.05). Conclusion  Compared with normal group,the volume of the nasal cavity in severe OSAHS patients without nasal disease significantly reduced. And while improving the upper airway collapse by H-UPPP & CCT, nasal capacity can be enlarged, and nasal ventilation can be improved.

Key words: rhinometry, acoustic, Sleep apnea, obstructive, polysomnography, Surgica1 operation