下颌前伸式阻鼾器的改良及对轻中度OSA的临床疗效评价  

Clinical Effect of Improved Mandibular Advancement Appliance on the OSA

作　　者：徐超[1] 秦猛[1] 何健民[1] 王俊莱[1] 谢宇平[2] 康宏[3] 马薇[2] 惠培林[2] 

机构地区：[1]甘肃省人民医院口腔修复科,甘肃兰州730000 [2]甘肃省人民医院睡眠医学中心,甘肃兰州730000 [3]兰州大学口腔医院修复科,甘肃兰州730000

出　　处：《口腔医学研究》2016年第7期737-741,共5页Journal of Oral Science Research

基　　金：甘肃省技术研究与开发专项计划(1305TCYA031);甘肃省卫生行业科研计划(GSWSKY2014-56)

摘　　要：目的:对临床常用的胶联一体下颌前伸式阻鼾器进行改良,评价其对轻、中度阻塞型睡眠呼吸暂停综合征(OSA)的临床疗效。方法:40例经多导睡眠呼吸监测(PSG)确诊为轻、中度OSA(5<AHI<30)的患者,随机将其均分为实验组及对照组,分别佩戴改良一体式阻鼾器和软压膜一体式阻鼾器,佩戴前及3月后行个人问卷调查及PSG监测,分别记录患者主观症状及睡眠参数变化,比较两组治疗前、后情况差异。结果:与治疗前比较,实验组18例的AHI下降了50%以上,客观有效率为90%,高于对照组55%;实验组治疗后N1%显著减少、N2%和N3%显著增加(P<0.05),对照组治疗前、后睡眠结构没有明显改善。实验组主观症状改善率高于对照组,无睡眠中阻鼾器脱落现象发生。结论:改良一体式阻鼾器对于轻、中度OSA有更好的治疗效果,在OSA的治疗中有广阔的临床应用价值。Objective：To improve the constructure of the common mandibular advancement appliance and evaluate the clinical effect of the modified oral appliance on the treatment of mild to moderate OSA.Methods：Forty patients with mild to moderate OSA（5AHI30）diagnosed by polysomnography（PSG）were included in the study.All subjects were divided into the experimental group and the control group randomly.The PSG was monitored for all subjects before and after 3months treatment respectively.The diversity was calculated between two groups on the basis of the AHI,LSaO2,and sleep structures recorded by PSG.At the same time,the subjective symptom was collected by questionnaire.Results：Compared to pretreatment,40 patients responded to the appliance therapy.Apnea hypopnea index in 18 patients of the experimental group was reduced by 50%,the efficiency was 90%,significantly higher than the control group.Lowest arterial oxygen saturation improved significantly in two groups（P〈0.05）.The N1% was shorter and the N2% and N3% were longer compared with preoperative status in the experimental group（P〈0.05）.Disordered sleep patterns in the control group improved not obviously.Falling of snore guards didn＇t occur in the experimental group.Conclusion：Modified oral appliance is more effective in the treatment of mild to moderate OSA than traditional mandibular advancement appliance.

关 键 词：睡眠呼吸暂停低通气综合征 阻塞型 改良一体式阻鼾器 多导睡眠呼吸监测 

分 类 号：R766[医药卫生—耳鼻咽喉科]