不同体位咽声反射对OSAHS病情评估的影响及其对OSAHS治疗效果评估的初探

荣婷; 马建刚; 赵宇亮; 蒋新霞; 王艳霞; 李新玉; 梁晓荣

doi:10.13201/j.issn.1001-1781.2019.02.007

不同体位咽声反射对OSAHS病情评估的影响及其对OSAHS治疗效果评估的初探

- 河北医科大学第二医院耳鼻咽喉科(石家庄, 050000)

详细信息

通讯作者: 马建刚,E-mail:mjgent79@163.com

中图分类号: R563.8

收稿日期: 2018-09-13

The evaluation of severity and treatment for OSAHS by acoustic pharyngometry which in different postures

- Department of Otorhinolaryngology Head and Neck Surgery, the Second Hospital of Hebei Medical University, Shijiazhuang, 050000, China

More Information

Corresponding author: MA Jiangang, E-mail: mjgent79@163.com

Received Date: 13 September 2018

摘要

摘要: 目的:探讨应用咽声反射测量咽腔情况的最佳体位及其对OSAHS治疗效果的评估。方法:以57例经PSG诊断为OSAHS的男性患者为鼾症组,以8例成年男性为正常对照组。鼾症组中11例重度OSAHS患者接受低温等离子悬雍垂腭咽成形术+舌根打孔消融术(手术组),8例接受无创持续正压通气(CPAP)治疗(CPAP组),余38例鼾症患者均选择减重及改变体位等保守治疗。所有受试者均进行PSG及坐位、仰卧位、侧卧位3种体位下的咽声反射测量,手术组及CPAP组分别治疗3个月后再进行3种体位下咽声反射测量。结果:咽腔最小截面积与AHI和血氧饱和度<90%的时间比例(SIT90)均呈显著负相关(P<0.01),仰卧位下咽腔最小截面积和AHI与SIT90的相关系数分别为-0.569和-0.478。仰卧位下咽腔最小截面积分别与BMI、颈围呈负相关(r=-0.265,P=0.033;r=-0.309,P=0.012)。OSAHS患者经手术及CPAP治疗后,咽腔最小截面积较治疗前明显增加,治疗前后分别与正常对照组比较,差异均有统计学意义(P<0.01)。结论:①咽腔最小截面积与AHI和SIT90均具有显著相关性,咽声反射可以初筛OSAHS患者;②仰卧位咽腔最小截面积显著小于坐位,其与AHI和SIT90的相关性更好,更能评估睡眠状态下咽腔的狭窄程度。③咽声反射作为一项简单、快速、非侵入性技术能够客观地评估手术及CPAP等治疗效果,为今后的临床诊断提供更有利的依据。
- 睡眠呼吸暂停低通气综合征 /
- 阻塞性 /
- 咽声反射 /
- 咽腔最小截面积
Abstract: Objective:To investigate the optimal position in application of acoustic pharyngometry to detect the pharyngeal condition and to assess its therapeutic effect on obstructive sleep apnea hypopnea syndrome (OSAHS).Method:Eight adult males were assigned to the normal group, and 57male patients with OSAHS diagnosed by polysomnograhy (PSG) were assigned to the snoring group.Of the snoring group, 11patients who were diagnosed severe OSAHS underwent low-temperature plasma uvulopaltopharyngoplasty (UPPP) and coblation-channeling of the tongue (CCT), were assigned to the operation subgroup;8patients underwent continuous positive airway pressure (CPAP), which was assigned to the CPAP subgroup.And remainders underwent conservative treatment, including weight loss and position change.Acoustic pharyngometry (three positions including sitting position, supine position and lateral position) and PSG exam were performed in all participants.Additionally, acoustic pharyngometry under three positions was conducted again in patients in the operation and CPAP subgroups three months after treatment.Result:The minimum cross-sectional area was negatively associated with both AHI and the percentage of time with oxygen saturation below 90% (SIT90) (P<0.01).The correlation coefficient of the minimum crosssectional area insupine position with AHI and SIT90 were r=-0.569, r=-0.478, respectively.Under supine position, the minimum cross-sectional area was negatively correlated with body mass index (BMI) (r=-0.265, P=0.033), and the minimum cross-sectional area was negatively associated with neck circumference (r=-0.309, P=0.012).The minimum cross-sectional area was significantly increased after treatment of OSAHS (both operation and CPAP), which was statistically different before and after treatment compared to the control group (P<0.01).Conclusion:① The minimum cross-sectional area is significantly correlated with AHI and SIT90, respectively.The acoustic pharyngometry can be used to screen OSAHS patients. ② In this study, the minimum crosssectional area under supine position is significantly smaller than that under sitting position.In addition, the minimum cross-sectional area under supine position harbored a better correlation with AHI and SIT90, which could better reflect the narrowness of pharyngeal cavity during sleep. ③ Acoustic pharyngometry could be a simple, rapid and non-invasive technique that can objectively evaluate the efficacy of surgical and CPAP methods, and provided a more favorable basis for future clinical work.
- sleep apnea hypopnea syndrome /
- obstructive /
- acoustic pharyngometry /
- minimum cross-sectional area

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