CT测量在阻塞性睡眠呼吸暂停低通气综合征诊断与治疗中的应用进展
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摘要
阻塞性睡眠呼吸暂停低通气综合征(OSAHS)是最常见的睡眠呼吸紊乱疾病,是造成人类死亡的四大疾病之一。研究表明,术前确定阻塞平面,可显著提高手术治愈率。CT扫描可以对上呼吸道各平面、各径线以及咽壁的厚度等进行准确的测量。本文介绍CT测量在OSAHS诊断与治疗中的应用进展。
【Objective】Obstructive sleep apnea hypopnea syndrome(OSAHS) is the most common disease in the sleepdisordered breathing, and one of four diseases which can cause human deaths. Research has shown that localization diagnosis of obstructive sleep apnea hypopnea syndrome before the operation may increase the curative ratio. CT scan can accurately measure the upper airway. The article gives an introduction of the application of CT scan in the diagnosis and treatment of OSAHS.
【Objective】Obstructive sleep apnea hypopnea syndrome(OSAHS) is the most common disease in the sleepdisordered breathing, and one of four diseases which can cause human deaths. Research has shown that localization diagnosis of obstructive sleep apnea hypopnea syndrome before the operation may increase the curative ratio. CT scan can accurately measure the upper airway. The article gives an introduction of the application of CT scan in the diagnosis and treatment of OSAHS.
引文
[1]Senaratna CV,Perret JL,Lodge CJ,et al.Prevalence of obstructive sleep apnea in the general population:A systematic review[J].Sleep Medicine Reviews,2017,34:70-81.
[2]Rapoport DM.POINT:Is the apnea-hypopnea index the best way to quantify the severity of sleep-disordered breathing?Yes[J].Chest,2016,149(1):14-16.
[3]Young T,Palta M,Dempsey J,et al.The occurrence of sleep disordered breathing among middle-aged adults[J].N Engl JMed,1993,328(17):1230-1235.
[4]Caples SM,Rowley JA,Prinsell JR,et al.Surgical modifications of the upper airway for obstructive sleep apnea in adults:a systematic reviewand Meta-Analysis[J].Sleep,2010,33(10):1396-1407.
[5]付忠良,周扬,杨怀安,等.OSAHS患者不同阻塞平面及阻塞性质术前评估的临床意义.临床耳鼻咽喉头颈外科杂志[J].2013,27(6):284-289.
[6]李树华,董莘,石洪金,等.CT测量在阻塞性睡眠呼吸暂停综合征上呼吸道狭窄定位诊断中的意义[J].中华耳鼻咽喉科杂志,2002,27(2):133-136.
[7]杜玲玲.阻塞性睡眠呼吸暂停低通气综合征患者的上气道CT影像学特征分析[J].基因组学与应用生物学,2018,37(11):4800-4806.
[8]Tang XL,Yi HL,Luo HP,et al.The application of ct to localize the upper airway obstruction plane in patients with OSAHS[J].Otolaryngol-Head Neck Surg,2012,147(6):1148-1153.
[9]粟丽,彭德昌,吴绯红,等.128层螺旋CT三维重建对OSAHS患者上气道应用价值的研究[J].实用放射学杂志,2016,32(7):1016-1019.
[10]王凯,董明敏.CT三维重建评估OSAHS患者上呼吸一期成形术效果[J].临床耳鼻咽喉头颈外科杂志,2012,26(3):104-107.
[11]黄雪蕾,刘昌华,魏国发,等.CT动态四维影像定位阻塞性呼吸暂停低通气综合征上气道阻塞部位的初步研究[J].中华老年口腔医学杂志,2016,14(6):321-325.
[12]Friedman M,Wilson MN,Pulver TM,et al.Measurements of adult lingual tonsil tissue in health and disease[J].Otolaryngology-Head and Neck Surgery,2010,142(4):520-525.
[13]章智敬,郑文龙,吴爱琴,等.阻塞性睡眠呼吸暂停低通气综合征上气道螺旋CT低剂量扫描的研究[J].中华全科医学,2016,14(9):1544-1549.
[14]吴绯红,彭德昌,苏筱芮,等,128层螺旋CT对阻塞性睡眠呼吸暂停低通气综合征咽旁间隙脂肪及颌下脂肪的研究[J].中国医学影像学杂志,2016,24(4):253-255.
[15]Sher AE,Thorpy MJ,Shprintzen RJ,et al.Predictive value of Müller maneuver in selection of patients for uvulopalatopharyngoplasty[J].Laryngoscope,1985,95(12):1483-1487.
[16]Maisel RH,Antonelli PJ,Iber C,et al.Uvulopalatophartngoplasty for obstructive sleep apnea:A community's experience[J].Laryngoscope,1992,102(6):604-607.
[17]Sullian CE,Issa FG,Berthon-Jones M,et al.Reversal of obstructive sleep apnoea by continuous poistive airway pressure through the nars[J].The Lancet,1981,317(8225):862-865.
[18]叶红,李涛平,冯媛,等.持续气道正压通气治疗对阻塞性睡眠呼吸暂停低通气综合征患者疗效的系统评价[J].中国循证医学杂志,2009,9(10):1067-1073.
[19]李全胜,肖洋,王军,等.上气道CT测量在持续气道正压通气治疗阻塞性睡眠呼吸暂停低通气综合征的意义[J].中国耳鼻咽喉头颈外科,2016,23(11):661-664.
[20]Wu SQ,Liao QC,Xu XX,et al.Effect of CPAP therapy on C-reactive protein and cognitive impairment in patients with obstructive sleep apnea hypopnea syndrome[J].Sleep Breath,2016,20(4):1185-1192.
[21]Kostopoulos K,Alhanatis E,Pampoukas K,et al.CPAP therapy induces favorable short-term changes in epicardial fat thickness and vascular and metabolic markers in apparently healthy subjects with obstructive sleep apnea-hypopnea syndrome(OSAHS)[J].Sleep Breath,2016,20(2):483-493.
[22]杨利波.老年阻塞性睡眠呼吸暂停低通气综合征并发咽喉反流疾病的抗反流疗效及其影响因素探讨[J].临床耳鼻咽喉头颈外科杂志,2016,12(8):645-648.
[23]孟怡彤,张晓东.阻塞性睡眠呼吸暂停综合征患者上气道的锥形束CT和螺旋CT三维测量的临床研究[J].临床口腔医学杂志,2018,34(6):344-347.
[24]李彦如,韩德民,叶京英,等.阻塞性睡眠呼吸暂停患者咽腔阻塞的整夜定位及影响因素分析[J].中华耳鼻咽喉头颈外科杂志,2006,41(6):437-442.
[25]闰智强,孙建军,陈曦,等.实时CT扫描与光纤内镜技术对阻塞性睡眠呼吸暂停低通气综合征上气道阻塞定位的对比研究[J].中华医学杂志,2012,92(48):3389-3392.
[2]Rapoport DM.POINT:Is the apnea-hypopnea index the best way to quantify the severity of sleep-disordered breathing?Yes[J].Chest,2016,149(1):14-16.
[3]Young T,Palta M,Dempsey J,et al.The occurrence of sleep disordered breathing among middle-aged adults[J].N Engl JMed,1993,328(17):1230-1235.
[4]Caples SM,Rowley JA,Prinsell JR,et al.Surgical modifications of the upper airway for obstructive sleep apnea in adults:a systematic reviewand Meta-Analysis[J].Sleep,2010,33(10):1396-1407.
[5]付忠良,周扬,杨怀安,等.OSAHS患者不同阻塞平面及阻塞性质术前评估的临床意义.临床耳鼻咽喉头颈外科杂志[J].2013,27(6):284-289.
[6]李树华,董莘,石洪金,等.CT测量在阻塞性睡眠呼吸暂停综合征上呼吸道狭窄定位诊断中的意义[J].中华耳鼻咽喉科杂志,2002,27(2):133-136.
[7]杜玲玲.阻塞性睡眠呼吸暂停低通气综合征患者的上气道CT影像学特征分析[J].基因组学与应用生物学,2018,37(11):4800-4806.
[8]Tang XL,Yi HL,Luo HP,et al.The application of ct to localize the upper airway obstruction plane in patients with OSAHS[J].Otolaryngol-Head Neck Surg,2012,147(6):1148-1153.
[9]粟丽,彭德昌,吴绯红,等.128层螺旋CT三维重建对OSAHS患者上气道应用价值的研究[J].实用放射学杂志,2016,32(7):1016-1019.
[10]王凯,董明敏.CT三维重建评估OSAHS患者上呼吸一期成形术效果[J].临床耳鼻咽喉头颈外科杂志,2012,26(3):104-107.
[11]黄雪蕾,刘昌华,魏国发,等.CT动态四维影像定位阻塞性呼吸暂停低通气综合征上气道阻塞部位的初步研究[J].中华老年口腔医学杂志,2016,14(6):321-325.
[12]Friedman M,Wilson MN,Pulver TM,et al.Measurements of adult lingual tonsil tissue in health and disease[J].Otolaryngology-Head and Neck Surgery,2010,142(4):520-525.
[13]章智敬,郑文龙,吴爱琴,等.阻塞性睡眠呼吸暂停低通气综合征上气道螺旋CT低剂量扫描的研究[J].中华全科医学,2016,14(9):1544-1549.
[14]吴绯红,彭德昌,苏筱芮,等,128层螺旋CT对阻塞性睡眠呼吸暂停低通气综合征咽旁间隙脂肪及颌下脂肪的研究[J].中国医学影像学杂志,2016,24(4):253-255.
[15]Sher AE,Thorpy MJ,Shprintzen RJ,et al.Predictive value of Müller maneuver in selection of patients for uvulopalatopharyngoplasty[J].Laryngoscope,1985,95(12):1483-1487.
[16]Maisel RH,Antonelli PJ,Iber C,et al.Uvulopalatophartngoplasty for obstructive sleep apnea:A community's experience[J].Laryngoscope,1992,102(6):604-607.
[17]Sullian CE,Issa FG,Berthon-Jones M,et al.Reversal of obstructive sleep apnoea by continuous poistive airway pressure through the nars[J].The Lancet,1981,317(8225):862-865.
[18]叶红,李涛平,冯媛,等.持续气道正压通气治疗对阻塞性睡眠呼吸暂停低通气综合征患者疗效的系统评价[J].中国循证医学杂志,2009,9(10):1067-1073.
[19]李全胜,肖洋,王军,等.上气道CT测量在持续气道正压通气治疗阻塞性睡眠呼吸暂停低通气综合征的意义[J].中国耳鼻咽喉头颈外科,2016,23(11):661-664.
[20]Wu SQ,Liao QC,Xu XX,et al.Effect of CPAP therapy on C-reactive protein and cognitive impairment in patients with obstructive sleep apnea hypopnea syndrome[J].Sleep Breath,2016,20(4):1185-1192.
[21]Kostopoulos K,Alhanatis E,Pampoukas K,et al.CPAP therapy induces favorable short-term changes in epicardial fat thickness and vascular and metabolic markers in apparently healthy subjects with obstructive sleep apnea-hypopnea syndrome(OSAHS)[J].Sleep Breath,2016,20(2):483-493.
[22]杨利波.老年阻塞性睡眠呼吸暂停低通气综合征并发咽喉反流疾病的抗反流疗效及其影响因素探讨[J].临床耳鼻咽喉头颈外科杂志,2016,12(8):645-648.
[23]孟怡彤,张晓东.阻塞性睡眠呼吸暂停综合征患者上气道的锥形束CT和螺旋CT三维测量的临床研究[J].临床口腔医学杂志,2018,34(6):344-347.
[24]李彦如,韩德民,叶京英,等.阻塞性睡眠呼吸暂停患者咽腔阻塞的整夜定位及影响因素分析[J].中华耳鼻咽喉头颈外科杂志,2006,41(6):437-442.
[25]闰智强,孙建军,陈曦,等.实时CT扫描与光纤内镜技术对阻塞性睡眠呼吸暂停低通气综合征上气道阻塞定位的对比研究[J].中华医学杂志,2012,92(48):3389-3392.