摘要
目的:探讨阻塞性睡眠呼吸暂停综合征(OSAS)患者,经药物诱导方法,在睡眠状态下行上气道多层螺旋CT的可行性,研究多层螺旋CT对阻塞性睡眠呼吸暂停综合征患者上气道阻塞部位的定位诊断价值。方法:选取经多导睡眠图监测(PSG)确诊的阻塞性睡眠呼吸暂停综合征患者114例,先行清醒状态下吸气末上气道CT扫描;后对其中109例患者经静脉缓慢注射咪唑安定,待患者在睡眠状态下呼吸暂停时,行上气道相应部位CT扫描;比较并测量两种状态下上气道狭窄水平的截面积及气道最小直径,并运用多层螺旋CT图像后处理技术,直观显示上气道形态。结果:①本组109例OSAS患者均顺利完成检查,成功率100%。②睡眠状态下,呼吸暂停时62例患者软腭后气道完全闭塞,其中26例伴有舌后气道闭塞,27例伴有舌后气道睡眠后较睡眠前狭窄,9例睡眠前后舌后气道无明显改变;40例患者软腭后气道较睡眠前狭窄,其中20例伴有舌后气道睡眠后较睡眠前狭窄,10例伴有舌后气道睡眠后完全闭塞,10例睡眠前后舌后气道无明显改变;7例患者睡眠前后CT扫描软腭后气道及舌后气道无明显改变。③软腭后气道平均最小截面积清醒相(72.60±45.15)mm2,睡眠相(8.26±18.16)mm2(P<0.01);舌后气道平均最小截面积清醒相(133.21±120.36)mm2,睡眠相(16.73±30.21)mm2(P<0.01)。软腭后气道平均最小直径清醒相(6.91±2.23)mm,睡眠相(1.18±2.14)mm(P<0.01);舌后气道平均最小直径清醒相(8.68±4.32)mm,睡眠相(1.68±2.22)mm(P<0.01)。结论:①运用药物诱导方法的睡眠状态下,对OSAS患者进行CT检查是安全可靠的。②多层螺旋CT结合图像后处理技术可真实再现OSAS患者睡眠状态下呼吸暂停发生时上气道的形态,对临床准确定位上气道狭窄或阻塞的部位和范围有指导意义。
Objective： To evaluate the feasibility of multi-slice spiral CT scan to localize upper airway stricture in patients with obstructive sleep apnea syndrome（OSAS） during drug-induced sleeping.Methods： One hundred and fourteen patients diagnosed as OSAS by polysomnography were included in the study.Multi-slice spiral CT scan covering upper airway was performed at the end of inspiration and clear upper airway images were obtained in waking.After injecting 5 mg of midazolam intravenously slowly in 109 patients,CT scan was performed at apnea and clear upper airway images were obtained in sleeping.Cross-section area and minimal diameter of airway were measured and the parameters were compared under those two states.Upper airway was displayed intuitionisticly by using post-processing techniques.Results： One hundred and nine patients with OSAS finished the examination with a success rate of 100%.Airway obstruction at retropalatal level was observed in 62 patients,among whom 26 were associated with airway obstruction at retroglossal level,27 with narrower airway at retroglossal level in sleeping compared with that in waking,and 9 with no significant change of the airway at retroglossal level after sleeping.Narrower airway at retropalatal level in sleeping compared with that in waking was observed in 40 patients,among whom 20 were associated with narrower airway at retroglossal level in sleeping compared with that in waking,10 with complete airway obstruction at retroglossal level in sleeping,and 7 with no significant change of the airway at both retropalatal and retroglossal levels before and after sleeping.Minimal mean cross-section area of airway at retropalatal level was（72.60±45.15）mm2 in waking and（8.26±18.16）mm2 in sleeping;and minimal mean cross-section area of airway at retroglossal level was（133.21±120.36）mm2 in waking and（16.73±30.21）mm2 in sleeping（P0.01）.Minimal mean diameter of airway at retropalatal level was（6.91±2.23） mm in waking and（1.18±2.14） mm in sleeping;and
出处
《浙江大学学报（医学版）》
CAS
CSCD
北大核心
2010年第2期168-173,共6页
Journal of Zhejiang University(Medical Sciences)
基金
浙江大学医学院中青年科研启动基金
