下颌前伸矫治器治疗睡眠呼吸暂停综合征的三维影像学评估  

Radiographic study on the efficacy of mandibular advancement in patients with obstructive sleep apnea syndrome

作　　者：李德宏 杨向红 周静 张凌鹏 舒文 

机构地区：[1]昆明市延安医院口腔科,云南昆明650051

出　　处：《上海口腔医学》2016年第2期208-211,共4页Shanghai Journal of Stomatology

基　　金：云南省科技厅-昆明医科大学联合专项(2009CD205);云南省科技厅应用基础研究面上项目(2012FB209);云南省科技厅科技惠民计划-社会发展(2014RA068)

摘　　要：目的 :研究下颌前伸矫治器对阻塞性睡眠呼吸暂停综合征(OSAS)患者的疗效及机制。方法 :采集80例OSAS患者应用下颌前伸矫治器治疗前、后的CT数据,利用三维影像重建技术测量上气道结构及容积变化,评价口腔矫治器(OA)的疗效及机制,采用SPSS17.0软件包对数据进行方差分析。结果:下颌前伸矫治器治疗OSAS多数患者主观症状缓解或消失,客观检测指标相应改善。OSAS患者存在上呼吸道的解剖性狭窄,戴入OA后,气道各分段截面积和容积均有变化,腭咽、喉咽段增大(P<0.01),口咽段减小(P<0.05)。结论:OSAS存在形态学病因机制,下颌前伸矫治器通过前伸下颌骨,使上气道减小,内部变化而更平滑稳定,减小涡流和狭窄,进而发挥治疗效果。PURPOSE： To investigate the efficacy and mechanism of mandibular advancement device（MAD） treatment on obstructive sleep apnea syndrome（OSAS） patients. METHODS： Eighty OSAS patients treated with a mandibular protraction appliance were included in the study. Three-dimensional reconstruction technique was used as to measure the changes of upper airway structure and volume before and after MAD treatment. The data was analyzed using SPSS 17.0 software package. RESULTS： The anatomic structure and the reinforcement of soft tissue＇s collapse in the upper airway changed after application of MAD in OSAS patients; velopharyngeal and laryngopharynx configuration was significantly increased（P〈0.01）, while oropharyngeal configuration was significantly decreased（P〈0.05）. CONCLUSIONS： This study demonstrated that pathogeny of OSAS based on morphological characteristics may be removed by mandibular advancement device, the mechanism of efficacy of MAD treatment can be the reduction of airway internal fluctuation and vortex of air.

关 键 词：睡眠呼吸暂停综合征 下颌前伸矫治器 上气道 截面积 

分 类 号：R766[医药卫生—耳鼻咽喉科]