CAJ | 학술논문

目的：探讨鼾症儿童上气道结构的CT形态学改变，以揭示鼾症儿童上气道结构异常及其与病情严重度的关系。方法：选择原发性鼾症（PS）组45例，阻塞性睡眠呼吸暂停低通气综合征（OSAHS）组73例，对照组40例。对3组儿童进行鼻咽部多层螺旋CT薄层扫描及三维重建，测量上气道软组织、骨性结构、空间结构并进行比较。结果：PS组、OSAHS组腺样体的面积、长度、厚度、体积，软腭的面积、体积，扁桃体面积均比对照组大（均P＜0.05）；鼻咽部气道体积，腭咽部气道的截面积、前后径、体积，鼻窦腔气体体积均比对照组小（均P＜0.05）；PS组、OSAHS组颈舌角减小，腺样体鼻咽腔比值（A/N）增大（均P＜0.01）。结论：CT扫描及三维重建技术检查鼾症患儿上气道结构，能从二维及三维结构明确鼾症儿童腺样体、扁桃体肥大导致上气道阻塞，且与成人相似存在软腭面积和体积增大，同时揭示了鼾症患儿常伴鼻窦炎及舌骨位置下移。
목적：탐토한증인동상기도결구적CT형태학개변，이게시한증인동상기도결구이상급기여병정엄중도적관계。방법：선택원발성한증（PS）조45례，조새성수면호흡잠정저통기종합정（OSAHS）조73례，대조조40례。대3조인동진행비인부다층라선CT박층소묘급삼유중건，측량상기도연조직、골성결구、공간결구병진행비교。결과：PS조、OSAHS조선양체적면적、장도、후도、체적，연악적면적、체적，편도체면적균비대조조대（균P＜0.05）；비인부기도체적，악인부기도적절면적、전후경、체적，비두강기체체적균비대조조소（균P＜0.05）；PS조、OSAHS조경설각감소，선양체비인강비치（A/N）증대（균P＜0.01）。결론：CT소묘급삼유중건기술검사한증환인상기도결구，능종이유급삼유결구명학한증인동선양체、편도체비대도치상기도조새，차여성인상사존재연악면적화체적증대，동시게시료한증환인상반비두염급설골위치하이。
Objective: To explore the structural features of upper airway morphological in snoring children with multislice spiral CT scan and post-processing techniques and to reveal the relationship between structural abnormalities and the severity of snoring.Methods: Children with snoring were enrolled and divided into pri-mary snorer (PS) group (n=45) and obstructive sleep apnea hypopnea syndrome (OSAHS) group (n=73) based on polysomnography (PSG). Another 40 cases were enrolled as the control group (n=40). Multislice spiral CT scan covering upper airway was performed and measurements of soft tissue, bone structure and spatial structure of the upper airway were obtained from a 3-dimensional segmentation using image analysis workstation of phil-lips Corp.Results: The area, length, thickness and volume of adenoid, the area and the volume of the soft pal-ate, the cross-sectional area of the tonsils in snoring children groups were signiifcantly higher than those in the control group (P<0.05). The cross-sectional area of the the velopharyngeal, the anterroposterior diameter of the velopharyngeal, the nasopharynx volumes and the velopharyngeal volumes, the paranasal sinus volumes in snor-ing children groups were signiifcantly reduced than that in the control group (P<0.05). The angle (α) was smaller and adenoid-nasopharynx ratio increased in snoring children groups than those in the control group (P<0.01). Conclusion: The snoring children have airway obstruction of various degrees at the upper airway because of the adenoid and tonsillar hypertrophy and the enlarged soft palate. Sinusitis is often complicatd and lower hyoid bone position moves down leading to increased upper airway resistance.