即刻口腔矫治器在阻塞性睡眠呼吸暂停低通气综合征诊断与治疗中的作用评价

中国口腔颌面外科杂志 ›› 2015, Vol. 13 ›› Issue (1): 58-62.

即刻口腔矫治器在阻塞性睡眠呼吸暂停低通气综合征诊断与治疗中的作用评价

胥雷, 孙红霞, 姚侃, 卢晓峰

上海交通大学医学院附属第九人民医院·口腔医学院口腔颅颌面科,上海市口腔医学重点实验室,上海 200011

收稿日期:2014-05-04 出版日期:2015-02-10 发布日期:2015-03-12
通讯作者: 卢晓峰,E-mail：lukeluxf@yahoo.com E-mail:xulei0517@163.com
作者简介:胥雷（1989- ）,男,在读硕士研究生

Immediate oral appliances in diagnosis and treatment of obstructive sleep apnea-hypopnea syndrome

XU Lei, SUN Hong-xia, YAO Kan, LU Xiao-feng

Department of Oral and Craniomaxillofacial Science, Ninth People′s Hospital, College of Stomatology, Shanghai Jiao Tong University School of Medicine, Shanghai Key Laboratory of Stomatology. Shanghai 200011, China

Received:2014-05-04 Online:2015-02-10 Published:2015-03-12

摘要/Abstract

摘要： 目的探讨即刻口腔矫治器在阻塞性睡眠呼吸暂停低通气综合征（OSAHS）诊断与治疗中的作用。方法 53例经夜间多导睡眠监测（PSG）诊断为轻、中、重度OSAHS患者,治疗前行PSG监测、鼻阻检查,拍摄头颅定位侧位片,于当天试戴即刻口腔矫治器并行PSG监测,治疗后完成舒适度调查问卷表。采用SPSS 17.0软件包对治疗前、后相关数据进行统计学分析。结果戴用即刻口腔矫治器后,患者主观症状改善,治疗后睡眠呼吸暂停低通气指数（AHI）低于治疗前,平均血氧饱和度（MSaO₂）、最低血氧饱和度（LSaO₂）均高于治疗前（P<0.05）。单因素方差分析发现,患者年龄、BMI、治疗前AHI、切牙间距离（配戴矫治器后上、下切牙间的水平距离）及覆盖距离（牙尖交错位时切牙覆盖距离）的变化对即刻口腔矫治器治疗效果的影响存在显著差异（P<0.05）。多元线性回归分析得到即刻口腔矫治器治疗效果的回归方程=67.956-0.731x₁-1.954x₂+0.411x₃+9.263x₄ （x₁：年龄,x₂：BMI,x₃：未配戴即刻矫治器前AHI,x₄：切牙间距离）,P<0.01,即回归效果显著,回归模型有统计学意义,决定系数R²为0.472。结论即刻口腔矫治器的应用不仅可以预测患者的初步治疗效果,而且可以为后续手术治疗提供有意义的指导。

关键词: 即刻口腔矫治器, 阻塞性睡眠呼吸暂停低通气综合征, 多导睡眠监测

Abstract: PURPOSES: To investigate the role of immediate oral appliances in diagnosis and treatment of obstructive sleep apnea-hypopnea syndrome (OSAHS). METHODS: Fifty-three patients (45 males, 8 females) with mild, moderate and severe OSAHS confirmed by polysomnogram (PSG) were included in this study. All the patients were evaluated by nasal resistance detection and cephalometric analysis before therapy. Meanwhile, immediate oral appliances were used with the evaluation of PSG. Paired t test and multiple linear regression analysis were carried out using SPSS 17.0 software package. RESULTS: There were significant differences in parameters evaluated between pretreatment and post treatment with immediate oral appliances both subjectively and objectively. It was found that the therapeutic effect of oral appliances had a significant difference with the changes of age, BMI, AHI before treatment, the horizontal distance between the upper and lower incisors wearing oral appliance and distance of overbite (P<0.05). Multiple linear regression equation on the treatment of immediate oral appliances was: =67.956-0.731x₁-1.954x₂+0.411x₃+9.263x₄ (x₁: age, x₂: BMI, x₃: AHI before treatment, x₄: the horizontal distance between the upper and lower incisors), P<0.01, R²=0.472. CONCLUSIONS: Immediate oral appliances could not only predict the therapeutic effect of oral appliances, but also provide support for subsequent treatment.

Key words: Immediate oral appliances, Obstructive sleep apnea-hypopnea syndrome, Polysomnogram

中图分类号:

R782.2

胥雷, 孙红霞, 姚侃, 卢晓峰. 即刻口腔矫治器在阻塞性睡眠呼吸暂停低通气综合征诊断与治疗中的作用评价[J]. 中国口腔颌面外科杂志, 2015, 13(1): 58-62.

XU Lei, SUN Hong-xia, YAO Kan, LU Xiao-feng. Immediate oral appliances in diagnosis and treatment of obstructive sleep apnea-hypopnea syndrome[J]. China J Oral Maxillofac Surg, 2015, 13(1): 58-62.

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