摘要
目的 :观察一种下颌前移性口矫器治疗阻塞性睡眠呼吸暂停 (OSA )的疗效并探讨其治疗原理 ,探讨应用颌面结构分析法来预测口矫器的疗效。 方法 :70例经多导睡眠仪 (PSG)检查确诊的 OSA患者 ,男性 6 3例 ,女性 7例 ,平均年龄 :(5 0 .5± 11.6 )岁 ,呼吸暂停指数 (AI) (34 .9± 2 1.3)次 /h,夜间最低血氧饱和度 (6 6 .3± 16 .5 ) %。经口腔科会诊后制作口矫器 ,治疗 3个月后复查 PSG检查。每例患者治疗前均在带及不带口矫器两种状态下摄头颅侧位片作颌面结构分析。 结果 :治疗后 AI由 (34 .9± 2 1.3)次 /h减至 (15 .6± 19.2 )次 /h(P<0 .0 0 0 1) ,夜间最低血氧饱和度由 (6 6 .3± 16 .6 ) %升至 (74.1± 15 .5 ) % (P<0 .0 0 1)。共有 45例患者 AI减少≥ 5 0 %。反应良好组患者缩颌较明显 ,前上面部长度较长 ,置入口矫器后下颌显著前突、上气道径增宽、长度缩短、上气道面积增大。 结论 :口矫器对部分 OSA患者具有确切疗效 ,其治疗作用可能主要与改善睡眠期上气道周围结构关系 ,保持气道通畅有关。
Objectives: To identify any craniofacial morphological changes induced by a mandibular repositioning oral appliance (MRA) and to explore the possibility of predicting the treatment response to MRA by cephalometric analysis in patients with obstructive sleep apnea (OSA). Methods: Seventy OSA patients [male/female: 63/7; age: (50.5±11.6) years; BMI: (27.6± 4.6 ) kg/m 2; AI: (34.9±21.3) episodes/hour; and oxygen saturation nadir: (66.3±16.5) %] were enrolled. MRA was fabricated individually for each patient after the consultation by a dentist. Polysomnographic (PSG) examination was repeated with MRA in place 3 months after the initiation of the MRA therapy. For cephalometric analysis, a pair of cephalograms of each patient was obtained, one with and another without MRA. Results and Conclusions: After 3 months' treatment, AI was (156±19.2) episodes/hour, significantly reduced compared with the pre treatment average AI (34.9±21.3 episodes/hour, P <0.000 1). Oxygen saturation nadir improved from (66.3±16.5)% (pre treatment) to (74.1±15.5)% (with MRA) ( P <0.001). A reduction of AI≥50% was achieved in 42 patients. Insertion of MRA led to anterior shift of the mandible, increase in upper airway width and area and decrease in upper airway length. Those with evident retrognathia and longer anterior upper facial height were more likely to benefit from the MRA management.
出处
《医学研究生学报》
CAS
2000年第1期4-7,共4页
Journal of Medical Postgraduates
