浙江大学学报（医学版）
浙江大學學報（醫學版）
절강대학학보（의학판）
JOURNAL OF ZHEJIANG UNIVERSITY MEDICAL SCIENCES
2010年
2期
168-173
,共6页
胡吉波%胡红杰%侯铁宁%高航翔%何健
鬍吉波%鬍紅傑%侯鐵寧%高航翔%何健
호길파%호홍걸%후철저%고항상%하건
睡眠呼吸暂停,阻塞性/诊断%睡眠呼吸暂停,阻塞性/病理学%体层摄影术,螺旋计算机%睡眠呼吸暂停综合征,阻塞性%气道梗阻%药物诱导睡眠%咪唑安定
睡眠呼吸暫停,阻塞性/診斷%睡眠呼吸暫停,阻塞性/病理學%體層攝影術,螺鏇計算機%睡眠呼吸暫停綜閤徵,阻塞性%氣道梗阻%藥物誘導睡眠%咪唑安定
수면호흡잠정,조새성/진단%수면호흡잠정,조새성/병이학%체층섭영술,라선계산궤%수면호흡잠정종합정,조새성%기도경조%약물유도수면%미서안정
Sleep apnea,obstructive/diag%Sleep apnea,obstructive/pathol%Tomography,spiral computed%Sleep apnea syndromes,obstructive%Airway obstruction%Drug-induced sleep%Midazolam
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)mm~2,睡眠相(8.26±18.16)mm~2(P<0.01);舌后气道平均最小截面积清醒相(133.21±120.36)mm~2,睡眠相(16.73±30.21)mm~2(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.
目的:探討阻塞性睡眠呼吸暫停綜閤徵(OSAS)患者,經藥物誘導方法,在睡眠狀態下行上氣道多層螺鏇CT的可行性,研究多層螺鏇CT對阻塞性睡眠呼吸暫停綜閤徵患者上氣道阻塞部位的定位診斷價值.方法:選取經多導睡眠圖鑑測(PSG)確診的阻塞性睡眠呼吸暫停綜閤徵患者114例,先行清醒狀態下吸氣末上氣道CT掃描;後對其中109例患者經靜脈緩慢註射咪唑安定,待患者在睡眠狀態下呼吸暫停時,行上氣道相應部位CT掃描;比較併測量兩種狀態下上氣道狹窄水平的截麵積及氣道最小直徑,併運用多層螺鏇CT圖像後處理技術,直觀顯示上氣道形態.結果:①本組109例OSAS 患者均順利完成檢查,成功率100%.②睡眠狀態下,呼吸暫停時62例患者軟腭後氣道完全閉塞,其中 26例伴有舌後氣道閉塞,27例伴有舌後氣道睡眠後較睡眠前狹窄,9例睡眠前後舌後氣道無明顯改變;40例患者軟腭後氣道較睡眠前狹窄,其中20例伴有舌後氣道睡眠後較睡眠前狹窄,10例伴有舌後氣道睡眠後完全閉塞,10例睡眠前後舌後氣道無明顯改變;7例患者睡眠前後CT掃描軟腭後氣道及舌後氣道無明顯改變.③軟腭後氣道平均最小截麵積清醒相 (72.60±45.15)mm~2,睡眠相(8.26±18.16)mm~2(P<0.01);舌後氣道平均最小截麵積清醒相(133.21±120.36)mm~2,睡眠相(16.73±30.21)mm~2(P<0.01).軟腭後氣道平均最小直徑清醒相(6.91±2.23)mm,睡眠相(1.18±2.14)mm(P<0.01);舌後氣道平均最小直徑清醒相(8.68±4.32)mm,睡眠相(1.68±2.22)mm(P<0.01).結論:①運用藥物誘導方法的睡眠狀態下,對OSAS患者進行CT檢查是安全可靠的.②多層螺鏇CT結閤圖像後處理技術可真實再現OSAS患者睡眠狀態下呼吸暫停髮生時上氣道的形態,對臨床準確定位上氣道狹窄或阻塞的部位和範圍有指導意義.
목적:탐토조새성수면호흡잠정종합정(OSAS)환자,경약물유도방법,재수면상태하행상기도다층라선CT적가행성,연구다층라선CT대조새성수면호흡잠정종합정환자상기도조새부위적정위진단개치.방법:선취경다도수면도감측(PSG)학진적조새성수면호흡잠정종합정환자114례,선행청성상태하흡기말상기도CT소묘;후대기중109례환자경정맥완만주사미서안정,대환자재수면상태하호흡잠정시,행상기도상응부위CT소묘;비교병측량량충상태하상기도협착수평적절면적급기도최소직경,병운용다층라선CT도상후처리기술,직관현시상기도형태.결과:①본조109례OSAS 환자균순리완성검사,성공솔100%.②수면상태하,호흡잠정시62례환자연악후기도완전폐새,기중 26례반유설후기도폐새,27례반유설후기도수면후교수면전협착,9례수면전후설후기도무명현개변;40례환자연악후기도교수면전협착,기중20례반유설후기도수면후교수면전협착,10례반유설후기도수면후완전폐새,10례수면전후설후기도무명현개변;7례환자수면전후CT소묘연악후기도급설후기도무명현개변.③연악후기도평균최소절면적청성상 (72.60±45.15)mm~2,수면상(8.26±18.16)mm~2(P<0.01);설후기도평균최소절면적청성상(133.21±120.36)mm~2,수면상(16.73±30.21)mm~2(P<0.01).연악후기도평균최소직경청성상(6.91±2.23)mm,수면상(1.18±2.14)mm(P<0.01);설후기도평균최소직경청성상(8.68±4.32)mm,수면상(1.68±2.22)mm(P<0.01).결론:①운용약물유도방법적수면상태하,대OSAS환자진행CT검사시안전가고적.②다층라선CT결합도상후처리기술가진실재현OSAS환자수면상태하호흡잠정발생시상기도적형태,대림상준학정위상기도협착혹조새적부위화범위유지도의의.
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)mm~2 in waking and (8.26±18.16)mm~2 in sleeping; and minimal mean cross-section area of airway at retroglossal level was (133.21±120.36)mm~2 in waking and (16.73±30.21)mm~2 in sleeping (P<0.01).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 minimal mean diameter of airway at retroglossal level was (8.68±4.32) mm in waking and (1.68±2.22) mm in sleeping (P<0.01). Conclusion: Multi-slice spiral CT with post-processing techniques can display the shape of the upper airway in patients with OSAS in sleeping,and can localize the upper airway stricture and assess its range accurately.
