声反射鼻腔测量对儿童腺样体肥大的临床研究

Clinical research of acoustic rhinometry in children with adenoid hypertrophy

关键词:  儿童  腺样体肥大  声反射鼻腔测量  鼻咽侧位片

Key words:  [Key words] children  adenoid hypertrophy  acoustic rhinometry  nasopharyngeal lateral X-ray

摘要:

[摘要] 目的　探讨声反射鼻腔测量对诊断儿童腺样体肥大的临床应用价值，对患儿的鼻腔、鼻咽腔容积等进行定量分析，探讨其鼻腔形态及通气情况，进而评价腺样体肥大对儿童鼻腔发育的影响。方法　对35例腺样体肥大患儿行鼻咽侧位片检查，根据其A/N比率（Adenoid/Nasopharynx，腺样体/鼻咽腔）分为3组：A/N≤0.60（共8例，男6例，女2例）；0.60＜A/N≤0.70（共8例，男5例，女3例）；A/N＞0.70（共19例，男13例，女6例）。再对上述受试者行声反射鼻腔测量计检查，得出鼻腔最小横截面积（MCSA）、鼻腔最小横截面积距离前鼻孔的距离（DMCA）、鼻腔阻力（NR）、鼻腔容积（NV）及鼻咽腔容积（NPV）。分析3组间各参数有无差异。结果　腺样体肥大儿童声反射鼻腔测量曲线特点为后段低平。随腺样体增大NR逐渐增大，NV、NPV则呈下降趋势。各组间MCSA、DMCA、NR、NV差异无显著性意义，P>0.05。 各组间NPV比较，差异有显著性意义（P=0.000）。结论　声反射鼻腔测量检查快速、无创，重复性好，可用于评估腺样体肥大对儿童鼻腔发育的影响，同时可应用于儿童阻塞性睡眠及暂停低通气综合征（OSAHS）的筛查工作，并为临床因人制宜采取不同的治疗方案提供参考。

Abstract:

[Abstract] Objective To assess the clinical application of acoustic rhinometry (AR) in children with adenoid hypertrophy. From the present study we would like to show that AR is a valid method to analyze nasal and nasopharyngeal volume of children suffering from adenoid hypertrophy in quantity. And then we can predict how the disorder of adenoid hypertrophy contributes to the growth of nose. Methods Thirty-five children with adenoid hypertrophy were examined with lateral X-ray and AR. Based on the adenoid /nasopharyngeal (A/N) volume, all children were assigned to three groups: 1) A/N≤0.60（total 8，boy 6，girl 2）；2) 0.6＜A/N≤0.70（total 8，boy 5，girl 3）；3) A/N＞0.70（total 19，boy 13，girl 6）. The parameters, including minimal cross-sectional area (MCSA), distance of the minimal cross-sectional area from the nostril (DMCA), nasal airway resistance (NR), nasal volume (NV), and nasopharyngeal volume (NPV), were achieved from the AR curve. Finally the above parameters were compared by the ANOVA. Results The characteristic feature of the AR curve in children with adenoid hypertrophy was flat in the posterior segment. In association with the degree of adenoid hypertrophy, NR increased gradually, while NV and NPV had a tendency to decrease. There was significant difference observed among the groups with respect to MCSA, DMCA, NR and NV. While comparison of NPV among the three groups showed a significant difference (P=0.000). Conclusion Acoustic rhinometry is a rapid, harmless, noninvasive method, and has a high reproducibility. Adenoid hypertrophy can affect the growth of the nose, which can be assessed by AR. Thus AR can be used to screen the children with OSAHS and provides information for individualized clinical treatment options.