成人口咽狭窄部位与OSAHS的相关性研究-外科学(耳鼻喉科)专业论文.docx

摘 要 题目：成人口咽狭窄部位与OSAHS的相关性研究。 目的：探讨成人口咽部阻塞平面情况与阻塞性睡眠呼吸暂停低通气综合征 (OSAHS)的发病、严重程度及口咽部塌陷程度的相关性。方法：选择经多导睡眠 检测仪(PSG)检查符合OSAHS的成人患者62例，记录患者的睡眠呼吸暂停低通气 指数(AHI)，最低血氧饱和度(SpO2)，经螺旋CT进行口咽部阻塞平面的扫描和测 量，并利用电子纤维喉镜观测阻塞平面在Muller动作下塌陷程度(T)，确定阻塞平 面最小截面积（S）的位置及大小。分析S分别与AHI、最低SpO2的相关关系，并 用线性回归分析上述指标的依存性。结果: ①成人口咽部阻塞平面最小截面积 （S）多位于口咽部RP区；②轻、中、重度OSAHS组AHI与S值呈负相关性，相 关系数分别为-0.380、-0.524、-0.633(P0.01)；轻、中、重度OSAHS组的最低SpO2 与S值呈正相关性，相关系数为0.509、0.670、0.529 (P0.01)；③塌陷程度(T) 与 OSAHS患者病情严重程度之间存在明显的相关性，F=11.263，P0.01。结论: AHI、 最低SpO2与S之间存在明显的相关性，S的大小影响呼吸暂停低通气事件的发生， 随着S的减小，OSAHS患病情严重程度也增加，OSAHS患者发生睡眠呼吸暂停 时缺氧程度也越严重。本研究可为OSAHS临床诊断、治疗及手术方法的选择提 供理论依据与技术参数。 关键词：OSAHS；阻塞平面；最小截面积；Muller实验 Abstract Title: The study of possible correlation of Pharyngeal obstruction plane and OSAHS. Objective: To investigate the possible correlation of Pharyngeal obstruction plane with the morbitidy, severity, and its collapsibility in obstructive sleep apnea and hypopnea syndromes (OSAHS). Methods: Sixty-two patients with OSAHS who has been performed polysomnography (PSG) were selected, and their apnea hypopnea index (AHI) and the lowest saturation of blood oxygen (SpO2) were recorded．All patients were scanned by CT to get the site and size of mini-cross sectional area of the Pharyngeal obstruction plane (S). And they were all performed by electrolaryngoscope and Muller test to determine the collapse degree of narrow pharyngeal cavity (T). The possible correlation of S, AHI, and SpO2 will be explored. Results: The value of the average S which is located at the RP of Pharyngeal. AHI are significantly correlated with S in statistics because the related coefficient of AHI of mild, moderate, and serious OSAHS are -0.380, -0.524, -0.633(P0 ． 01), respectively. While the related coefficient of minimum SpO2 of mild, moderate, and serious OSAHS are 0.509, 0.670, 0.529(P0.01), respectively, that is to say, SpO2 are significantly correlated with S in statistics. The collapse degree of narrow pharyngeal cavity(T) is significantl