鼻声反射和鼻阻力测量在阻塞性睡眠呼吸暂停低通气综合征患者术后鼻功能评估中的应用

Application of acoustic rhinometry and rhinomanometry in evaluation of postoperative nasal function in OSAHS patients with abnormal nasal structures treated by nasal cavity ventilation expansion techniques

摘要:

目的 探讨鼻声反射和鼻阻力测量在鼻腔扩容手术治疗鼻腔结构异常致阻塞性睡眠呼吸暂停低通气综合征（OSAHS）患者鼻功能评估中的应用。方法 选择经多导睡眠监测（PSG）确诊且经视觉模拟量表（VAS）评估具有鼻塞、鼻内镜及鼻窦CT检查证实结构异常的成年OSAHS患者36例作为研究对象。根据检查结果实施个体化的鼻内镜下鼻腔扩容手术。术前及术后6个月所有患者均进行VAS评估、鼻声反射测量和鼻阻力测量，比较手术前后测量结果。结果 患者术前VAS评估计分、鼻腔吸气总阻力、鼻腔呼气总阻力、鼻腔最小横截面积、鼻腔容积、最小横截面积至前鼻孔的距离分别为（6.97±1.27）分、（2.07±1.07）kPa/L·S^-1、（2.15±1.09）kPa/L·S^-1、（0.39±0.16）cm²、（2.20±0.97）cm³及（1.97±0.47）cm；术后6个月分别为（1.33±0.92）分、（1.69±1.03）kPa/L·S^-1、（1.90±1.02）kPa/L·S^-1、（0.51±0.17）cm²、（2.73±1.05）cm³及（2.19±0.46）cm。手术前后各指标差异均具有统计学意义（P均<0.05）。结论 鼻腔扩容术可以显著改善伴有鼻腔结构异常的OSAHS患者的鼻通气功能，鼻声反射和鼻阻力测量能客观评估鼻腔扩容手术治疗前后伴有鼻腔结构异常的OSAHS患者鼻通气功能的变化。

Abstract:

Objective To study the applications of acoustic rhinometry and rhinomanometry in evaluation of postoperative nasal function in obstructive sleep apnea-hypopnea syndrome (OSAHS) patients with abnormal nasal structures treated by nasal cavity ventilation expansion techniques. Methods Thirty-six adult patients suffering from polysomnography (PSG)-confirmed OSAHS combined with nasal obstruction and abnormal nasal structures were selected as the study subjects. Endoscopic nasal cavity ventilation expansion techniques were performed individually in all the patients according to the results of the examination. Before surgery and 6 months after surgery, they all filled visual analogue scale (VAS) and took the examinations of acoustic rhinometry and rhinomanometry.Results Preoperative VAS score, total inspiratory resistance, total expiratory resistance, minimal cross-sectional area, nasal volume and the distance between the nostril and minimal cross-sectional area were(6.97±1.27),(2.07±1.07)kPa/L·S^-1,(2.15±1.09)kPa/L·S^-1,(0.39±0.16)cm²,(2.20±0.97)cm³ and (1.97±0.47) cm, respectively. At 6 months postoperatively, they were (1.33±0.92),(1.69±1.03)kPa/L·S^-1,(1.90±1.02)kPa/L·S^-1,(0.51±0.17)cm²,(2.73±1.05)cm³ and (2.19±0.46) cm. There were statistically significant differences in all indexes before and after surgery(P<0.05). Conclusions Endoscopic nasal cavity ventilation expansion techniques can significantly improve the subjective and objective nasal ventilation functions in OSAHS patients with abnormal nasal structures. Acoustic rhinometry and rhinomanometry may objectively evaluate the changes of nasal function in these patients managed with endoscopic nasal cavity ventilation expansion techniques.