梁业伟　文加林

[摘要] 目的 探讨鼻咽部数字化摄影对于儿童腺样体肥大的诊断价值。 方法 方便选取该院2013年10月—2016年6月收治的怀疑咽后壁腺样体肥大患儿60例，患儿全部行鼻咽部侧位片数字化摄影，测量其腺样体厚度、鼻咽腔宽度及后气道宽度，并计算其腺样体指数（A/N），结合临床资料进行回顾性分析。 结果 数字化影像测量对儿童腺样体肥大的诊断准确率为100%。大多数患儿腺样体不同程度增厚，8例患儿A/N≤0.60；30例患儿A/N在0.61～0.70之间；22例患儿A/N≥0.71。同时PAS≤5 mm的20例；6～10 mm的33例；≥10 mm的7例。结论 鼻咽部侧位片数字化摄影测量结果与临床表现及鼻内镜、手术结果具有较高一致性，是了解儿童腺样体肥大程度的经济适用、安全有效方法，为临床选择治疗方法提供重要参考依据。

[关键词] 腺样体肥大；数字化摄影；A/N比值

[中图分类号] R614 [文献标识码] A [文章编号] 1674-0742（2018）03（c）-0179-03

Analysis of Value of Pharynx Nasalis Digital Photography in Diagnosis of Children with Adenoidal Hypertrophy

LIANG Ye-wei， WEN Jia-lin

Department of Radiology， Kunming First Peoples Hospital， Kunming， Yunnan Province， 650011 China

[Abstract] Objective To study the value of pharynx nasalis digital photography in diagnosis of children with adenoidal hypertrophy. Methods 60 case of children suspected with adenoidal hypertrophy admitted and treated in our hospital from October 2013 to June 2016 were convenient selected and all children used the pharynx nasalis digital photography， and the adenoid thickness， width of pharynx nasalis， posterior airway width were measured， and the A/N was calculated， and reviewed according to the clinical data. Results The accurate rate of pharynx nasalis digital photography in diagnosis of children with adenoidal hypertrophy was 100%， and the adenoid thickened to different degrees， and there were 8 cases whose A/N≤0.60， 30 cases whose A/N was between 0.61 to 0.70， 22 cases whose A/N≥0.71， at the same time， there were 20 cases whose PAS≤5 mm and 33 cases whose PAS was 6 to 10 mm and 7 cases whose PAS ≥10 mm. Conclusion The measurement results and clinical manifestations of pharynx nasalis digital photography is highly consistent with the operation results， which is a safe and effective method of mastering the adenoidal hypertrophy in children， and it can provide important reference for the clinical selection of treatment method.

[Key words] Adenoidal hypertrophy； Digital photography； Ratio of A/N

腺样体又称咽扁桃体或增值体， 为一群淋巴组织，位于鼻咽顶与后壁交界处，出生时即已存在并逐渐增长，约5～6岁达到最大，10岁以后逐渐退化、萎缩，14岁以后呈成人状态。儿童期因感染等因素导致腺样体肿大、发炎，影响鼻咽腔通气功能，出现鼻塞、张口呼吸、打鼾等症状，同时可能阻塞鼻窦、咽鼓管开口，导致鼻窦炎、中耳炎等疾病。临床常用鼻咽镜或鼻内镜进行检查，但儿童因鼻咽腔狭小且不易配合，常给检查造成困难。而鼻咽部侧位数字化摄影能清晰显示鼻咽腔情况，并对相关指标进行测量、计算，以评估腺样体肥大及后气道狭窄情况，为临床诊治腺样体肥大提供依据。……