摘要
目的:探索一种适用于治疗凸面型阻塞性睡眠呼吸暂停低通气综合征(obstructive sleep apnea-hypopnea syndrome,OSAHS)患者的改良双颌前徙手术术式,评估应用改良双颌前徙手术治疗凸面型OSAHS患者的效果。方法:应用改良双颌前徙手术治疗的中度到重度OSAHS患者共8人,患者于术前3个月和术后6个月分别进行多导睡眠图仪(polysomnography,PSG)检查,于术前和术后3个月分别拍摄头颅定位侧位X线片,并进行X线头影测量分析,于术后6个月进行主观问询调查。结果:8名患者术前低通气指数(AHI)平均为(40.1±16.1)/h,术后AHI平均为(5.4±3.8)/h;术前最低血氧饱和度(SaO2)平均为(72.4±7.2)%,术后最低SaO2平均为(90.6±2.1)%;通过X线头影测量结果发现,SNA术前为(80.9±1.7)°,术后为(82.9±1.5)°;SNB术前为(72.5±2.6)°,术后为(81.5±1.7)°;舌根部至咽后壁距离(PAS)术前为(5.3±1.6)mm,术后为(10.8±1.8)mm。所有患者的日间嗜睡及睡眠打鼾症状均得到明显改善,其中7名患者自觉日间嗜睡及睡眠打鼾症状消失。结论:改良的双颌前徙手术与传统的双颌前徙手术的作用机制相同,术后的效果相当,适用于治疗凸面型OSAHS患者。改良双颌前徙手术通过拔除上下颌前磨牙,使上、下颌骨后部前移,而前部骨段的位置不变或者不会过度前移,这样既能改善患者的睡眠呼吸情况,同时又不会使患者术后的面型显得更突。
Objective：To evaluate the modified maxillomandibular advancement （MMMA） technique for the treatment of obstructive sleep apnea syndrome （OSAS） in yellow race of convex profile.Methods：Eight patients underwent MMMA for the treatment of OSAHS.All the patients underwent pre-surgical and postsurgical polysomnography,cephalometric analysis and objective results assessment.Results：The preoperative polysomnography results of the patients were as follows：apnea-hypopnea index,（40.1±16.1） per hour;lowest oxygen saturation,（72.4±7.2）%.The postoperative polysomnography results were as follows：apnea-hypopnea index,（5.4±3.8） per hour;lowest oxygen saturation,（90.6±2.1）%.The mean preoperative SNA was （80.9±1.7）°,and the mean postoperative SNA was （82.9±1.5）°.The mean preoperative SNB was （72.5±2.6）°,and the mean postoperative SNB was （81.5±1.7）°.The mean preoperative PAS was （5.3 ±1.6）mm,and the mean postoperative PAS was （10.8 ±1.8） mm.Conclusion：The preliminary review has demonstrated that the modified MMA technique for the treatment of OSAS is highly effective in the treatment of severe OSAS without the significant facial profile change commonly associated with the traditional MMA technique.With the introduction of this modified MMA technique for the treatment of OSAS,skeletal surgery may be less perceived as an unattractive treatment modality due to the markedly reduced anticipated facial changes after surgery.
出处
《北京大学学报（医学版）》
CAS
CSCD
北大核心
2010年第5期570-574,共5页
Journal of Peking University:Health Sciences
基金
"十一五"国家科技支撑计划(2007BAI18B04)资助项目~~
关键词
睡眠呼吸暂停
阻塞性
口腔外科手术
双颌前徙术
Sleep apnea,obstructive,Oral surgical procedures； Maxillomandibular advancement；
