双颌前徙术治疗阻塞性睡眠呼吸暂停低通气综合征及长期稳定性的研究  

Maxillomandibular advancement surgery for obstructive sleep apnea syndrome and long-term surgical stability

作　　者：李阳[1] 伊彪[1] 王兴[1] 李自力[1] 梁成[1] 王晓霞[1] 

机构地区：[1]北京大学口腔医学院·口腔医院颌面外科,100081

出　　处：《中华口腔正畸学杂志》2011年第3期130-134,共5页Chinese Journal of Orthodontics

摘　　要：目的采用双颌前徙术治疗中度到重度的中国阻塞性睡眠呼吸暂停低通气综合征（obstructivesleepapnea-hypopneasyndrome，OSAHS）患者，评估术后效果、治病机理及长期稳定性。方法应用双颌前徙术治疗的中度到重度OSAHS患者共9人。患者分别于T1（术前3个月内）、T2（术后3～6个月）及T3（术后最长随访期，至少1年以上）分别进行多导睡眠图仪检查、拍摄头颅定位侧位x线片进行x线头影测量及三维螺旋CT上气道重建。结果9名患者睡眠呼吸暂停低通气指数（apneaandhypopneaindex，AHI）在T1为49．5次／／l,时，T2为7．8次／小时，T3为8．5次／11,时；睡眠时最低血氧饱和度（10westoxygensaturation，I。SAT）在T1为70．2％，T2为91．8％，T3为90．3％。通过术后长期随访，患者颌骨的位置及上气道各层面的测量值相对稳定，主观症状的改善也表现出很好的稳定性。结论双颌前徙术非常适用于治疗上下颌骨发育不足的OSAHS患者，术后长期随访显示双颔前徘术治疗OSAHS具有较好的长期稳宁件．Objective To evaluate the outcome of maxillomandibular advancement （MMA） for the treatment of obstructive sleep apnea hypopnea syndrome （OSAHS） in China and to examine the long-term surgical stability. Methods Nine patients underwent MMA for the treatment of OSAHS. All the patients were examined with polysomnography, cephalometric analysis and 3-dimentional CT at T1（3 months before surgery）,T2（3-6 months after surgery） and T3C〉1 year after surgery）. Results Mean apnoea/hypopnoea index （AHI） decreased from 49. 5 events · h ^-1 before therapy to 7. 8 events, h 1 3 months postoperatively and to 8. 5 events · h ^-1 one year after surgery. Oxygen saturation significantly increased after surgery. No significant changes were found in follow-up data between 3 months and one year after surgery. The position of the maxilla and mandible,measurements in upper airway and postoperative objective measures of efficacy showed relatively stable. Conclusions The MMA technique for the treatment of OSAHS was effective in patients with severe OSAHS. The results from this study indicated that maxillomandibular advancements was relatively stable.

关 键 词：睡眠呼吸障碍疾患 睡眠呼吸暂停低通气综合征 双颌前徙术 

分 类 号：R766[医药卫生—耳鼻咽喉科]