体位变化对健康儿童鼻腔及鼻咽气道几何形态和鼻气道阻力的影响

目的研究健康儿童不同体位下声反射鼻腔测量参数，探讨体位变化对鼻腔几何形态和鼻阻力的影响情况。方法将73例健康儿童按年龄分组：3～6岁组、7～10岁组及11～14岁组，对其进行声反射鼻腔测量，得到坐位、仰卧位及侧卧位时的声反射鼻腔测量参数值，包括鼻腔和鼻咽容积以及鼻阻力的变化。结果各年龄组左侧卧位、右侧卧位及仰卧位总鼻气道阻力比坐位时增大（P〈0．05），左侧卧位与右侧卧位、仰卧位总鼻气道阻力对比差异无统计学意义（P〉0．05）。左侧卧位、右侧卧位及仰卧位双侧鼻腔容积（nasal cavity volume，NCV）、双侧鼻咽容积（nasopharyngeal volume，NPV）及总鼻腔最小横断面积（nasal minimal cross-sectional area，NMCA）与坐位比较减小，差异具有统计学意义（P〈0．05）；左侧卧位、右侧卧位及仰卧位相比差异无统计学意义（P〉0．05）。3～6岁组坐位总鼻气道阻力与7～10岁组、11～14岁组比较增大，7～10岁组总鼻气道阻力与11～14岁比较增大，差异均有统计学意义（P值均〈0．05）。3～6岁组坐位双侧NCV、双侧NPV及总NMCA较7～10岁组、11～14岁组减小，7～10岁组与11～14岁组比较减小，差异均具有统计学意义（P值均〈0．05）。结论体位变化在儿童亦可引发与成人相似的鼻腔几何学和气流动力学的变化。声反射鼻腔测量在研究儿童鼻及鼻咽部气道几何形态方面具有重要的意义。

Effects of postural changes on geometry of nasal and nasopharyngeal airway and nasal resistance in healthy children

OBJECTIVE: To investigate the normal ranges of the following parameters: nasal airway resistance (NAR), nasal cavity volume (NCV), nasopharyngeal volume (NPV) and nasal minimal crosssectional area (NMCA), and the effect of postural changes on nasal cavity geometry and nasal airway resistance. METHODS: Seventy three healthy children had acoustic rhinometry (AR) test in different body positions. RESULTS: In each group, the NAR of the healthy children in the lateral, and supine positions were significantly greater than that in the sitting position, and there were no significant differences among the NAR in lateral, and supine positions; the total NCV, NPV, NMCA of the healthy children in the lateral and supine positions were significantly smaller than that in the sitting position (P < 0.05). The NAR of the 3-6 year-old group was significantly greater than that of the 7-10 and 11-14 year-old groups, significant differences were also found between the last two groups; NAR in 7-10 year-old group were greater than that in the 11-14 year-old group (all P < 0.05). The total NCV,the total NPV and the total NMCA of the 3-6 year-old group were significantly smaller than that of the 7-10 and 11-14 year-old groups, significant differences were also found between the last two groups (all P < 0.05). All three parameters' numerical value in 7-10 year-old group were smaller than that in the 11-14 year-old group. CONCLUSIONS: Postural changes may alter the NAR and the nasal cavity geometry in normal children.