腺样体肥大论文：腺样体肥大儿童多导睡眠监测与鼻咽侧位片相关性分析

腺样体肥大：腺样体肥大儿童多导睡眠监测与鼻咽侧位片相关性分析 腺样体肥大论文:腺样体肥大儿童多导睡眠监测与鼻咽侧位片相关性分析 【中文摘要】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,在鼻咽侧位平片上,A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(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。 【英文摘要】To study the correlation research between PSG and X-ray nasopharyngeal lateral plain film of Adenoidal hypertrophy in children.Methods 133 children aged from 2 to 10 years old with adenoidal hypertrophy were selected for the experiment. All of them have not suffered from nasal deseases, such as rhinitis, nasosinusitis and deviation of nasal septum, craniocerebral injuries, acute upper respiratory tract infection within the latest one month. Adenoid examination: nasopharyngeal lateral plain films were taken in erect position or supine position during the patients’intakeperiod,5cm for the anode-film distance and 2cm under the external auditory canal opening. Method of measurement:thickness of adenoid and breadth of cavum nasopharyngeum were measured by electronic ruler on screens. A represent the thickness of adenoid. N represent the cavum nasopharyngeum. More than 7 hours night’ sleep was monitored by polysomnography (PSG) according to the recently international standard. The monitoring item include several index such as snoring, airflow of mouth and nasal, oxygen saturation, movement of chest and abdomen and body position, and then summarizing sleep(test length, sleep period time, awake time, snoring times) and respiratory disturbance (apnea hyponea index, AHI), average blood oxygen levels, lowest saturation of blood oxygen(LsaO2). The correlation between the thickness of adeniod and PSG was observed according to the above items.Results The relationship between AHI and A/N ratio on X-ray nasopharyngeal lateral plain film present positive correlation, A/N ratio and LSaO2 show negative correlation when A/N ratio is more than 0.7. There is no correlation between A/N and AHI when A/N is less than 0.7.Conclusion The degree of adnoidal hypertrophy is the main reason to children’OSAHS and can be reflected by both A/N1 and A/N2 ratio. In addition, tonsil could not be regarded as alone reason to children’s OSAHS. 【关键词】腺样体肥大 OSAHS AHI A/N比值 LSaO2 【英文关键词】adenoidal hypertrophy OSAHS AHI A/N ratio LSaO2 【目录】腺样体肥大儿童多导睡眠监测与鼻咽侧位片相关性分析 摘要 2-3 Abstract 3 引言 5-6 第一章 材料 与方法 6-8 1.1 研究对象 6 1.2 主要实验仪器 6 1.3 主要实验方法 6-7 1.3.1 摄片及测量方法 6 1.3.2 多导睡眠监测 6-7 1.4 统计学处理 7-8 第二章 结果 8-17 2.1 A/N比值&AHI(呼吸暂停低 通气指数) 8-12 2.2 A/N比值与AHI、最低血氧饱和度之间的关系 12-17 第三章 讨论 17-21 3.1 腺样体肥大儿童鼻咽侧位X线片检查及测量 17-19 3.2 腺样体肥大儿童多导睡眠监测(POLYSOMNOGRAPHY,PSG) 19-20 3.3 腺样体肥大患儿鼻咽侧位片测量与多导睡眠监测数据的相关性 20-21 第四章 结论 21-22 参考文献 22-24 综述 24-38 综述参考文献 35-38 致谢 38-39 【备注】索购全文在线好友请加:139938848 同时提供论文写作一对一指导和论文发表委托服务。