腺样体肥大儿童多导睡眠监测与鼻咽侧位片相关性分析

发布时间：2018-12-25 09:10

【摘要】：目的 探讨腺样体肥大儿童多导睡眠监测与鼻咽侧位X线片检测数据的相关性,指导临床诊断及确定手术指征。 方法 选择年龄2-10岁腺样体肥大儿童133名,所有观察对象无鼻炎、鼻窦炎及鼻中隔偏曲等鼻腔病变,无颅脑疾病,最近一个月无急性上呼吸道感染。腺样体检查：拍摄仰卧位吸气期鼻咽侧位平片,靶—片距120cm,中心点在外耳道口前下各2cm处,下颌稍抬高。测量方法：在监视器上用电子测量尺在鼻咽侧位片上测量腺样体的厚度及鼻咽腔的宽度,在标准鼻咽侧位平片上,A表示腺样体的厚度,为腺样体下缘最凸点至枕骨斜坡颅外切线间的垂直距离。N1为腺样体最凸部位的鼻咽腔宽度,即垂线的反向延长线与硬腭后端或软腭的交点和枕骨斜坡颅外切线的垂直距离；N2为翼板根部和斜坡颅外面的连接点与硬腭后上端的连线。采用冰岛邦德安佰X100睡眠监测仪、睡眠分析软件,按国际通用标准导联连接方法连续监测患儿夜间至少7小时睡眠。监测项目包括鼾声、口鼻气流、血氧饱和度、胸腹运动、体位等指标,进行睡眠总结(监测时间、睡眠期时间、总觉醒时间、总睡眠时间、打鼾次数)；呼吸紊乱总事件(呼吸紊乱指数、AHI)；血氧总结(平均Sa02水平、LSaO2),观察腺样体的厚度与多导睡眠监测的相关性。 结果 鼻咽侧位X线片A/N比值测量数据0.7与PSG监测指标AHI呈正相关,与最低血氧饱和度呈负相关。A/N比值≤0.7时与PSG监测指标无相关性 结论 A/N1与A/N2比值测量均能反映儿童腺样体肥大程度,腺样体肥大对儿童OSAHS影响明显,扁桃体肥大不做为一个独立的因素。
[Abstract]:Objective to investigate the correlation between polysomnography and lateral nasopharynx X-ray examination in children with adenoid hypertrophy. Methods 133 children aged 2-10 years with adenoid hypertrophy were selected. All the subjects were not affected by rhinitis, sinusitis and nasal septum deviation, no craniocerebral diseases, and no acute upper respiratory tract infection in the last month. Adenoid examination: the lateral nasopharynx plain film was taken in supine position during inspiratory period, the distance between target and film was 120 cm, the center point was at the anterior and inferior 2cm of the external auditory canal, and the mandible was slightly raised. Methods: the thickness of adenoid and the width of nasopharynx cavity were measured on the lateral nasopharynx film by electronic measuring ruler on the monitor. On the standard nasopharyngeal lateral plane film, A indicated the thickness of the adenoid. N1 is the width of nasopharynx cavity in the most protruding part of adenoid, that is, the reverse extension of perpendicular line to the intersection point of the posterior part of hard palate or soft palate and the vertical distance of the extracranial tangent of occipital bone to the posterior part of hard palate or soft palate. N2 is the connection between the base of the wing plate and the outside of the Clivus cranium and the upper end of the hard palate. With the help of Bandanbai X 100 sleep monitor and sleep analysis software, the children were monitored for at least 7 hours of sleep at night according to the international standard lead connection method. The monitoring items included snoring, mouth and nose airflow, blood oxygen saturation, chest and abdomen movement, posture and so on, and summarized sleep (monitoring time, sleep period, total awakening time, total sleep time, snoring times). Total events of respiratory disorders (respiratory disorder index, AHI); blood oxygen summary (average Sa02 level, LSaO2), to observe the correlation between adenoid thickness and polysomnography monitoring. Results A / N ratio of nasopharynx lateral radiographs was positively correlated with PSG monitoring index (AHI). There was no correlation between A/N1 and PSG when the ratio of A / N 鈮，

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