两种口腔矫治器治疗老年OSAS的临床疗效评价  

Clinical evaluation of two adjustable oral appliances in the treatment of elderly patients with obstructive sleep apnea syndrome

作　　者：孙力 路荣建 谢潇 王家柱[4] 王晶晶 黄阳[4] 栢长青 葛成 SUN Li;LU Rong-jian;XIE Xiao;WANG Jia-zhu;WANG Jing-jing;HUANG Yang;BAI Chang-qing;GE Cheng(Outpatient Department of Logistics Support Department of PLA Military Commission,Beijing 100842,China)

机构地区：[1]不详 [2]解放军总医院第五医学中心南院区口腔科,北京100071 [3]空军司令部门诊部,北京100842 [4]解放军总医院第一医学中心口腔科,北京100853 [5]解放军总医院第五医学中心南院区呼吸科,北京100071

出　　处：《中华老年口腔医学杂志》2020年第1期16-20,共5页Chinese Journal of Geriatric Dentistry

基　　金：首都临床特色应用研究(Z171100001017192);北京市优秀人才培养资助(No.2017000062586G232)。

摘　　要：目的:探讨两种口腔矫治器治疗老年阻塞性睡眠呼吸暂停综合征(obstructive sleep apnea syndrome,OSAS)的临床疗效。方法:选取40例老年OSAS患者,随机分为A、B两组,分别戴用silensor口腔矫治器和压膜式改良activator矫治器治疗。治疗6个月后,通过多导睡眠监测和上气道形态的CBCT测量,并结合患者主诉症状改善情况,评价两种口腔矫治器对老年OSAS患者的疗效。结果:戴用两种口腔矫治器后,老年OSAS患者的打鼾、憋醒和嗜睡症状得到改善;最低血氧饱和度升高,呼吸紊乱指数和呼吸暂停时间明显降低,差异具有统计学意义(P<0.05)。CBCT扫描显示腭咽和舌咽气道矢状径、面积和体积较治疗前明显增大,组间差异无统计学意义(P>0.05)。而silensor矫治器舒适度显著性优于改良activator式矫治器。结论:两种口腔矫治器对老年OSAS均有良好的临床疗效,silensor可调式矫治器的舒适性更好。Objective:To investigate the clinical efficacy of two kinds of oral appliances in the treatment of elderly obstructive sleep apnea syndrome(OSAS).Methods:40 elderly OSAS patients were randomly divided into A and B groups.They were treated with silensor orthodontic appliance and modified activator orthodontic appliance.After 6 months of treatment,the effect of two kinds of oral appliances on elderly OSAS patients was evaluated by polysomnography and CBCT measurement of upper airway morphology,combined with the improvement of complaint symptoms.Results:The symptoms of snoring,waking up and sleepiness in elderly OSAS patients were improved after wearing two kinds of oral appliances,and the lowest oxygen saturation was increased,while the respiratory disorder index and apnea time were significantly decreased(P<0.05).CBCT scan showed that the sagittal diameter,area and volume of palatopharyngeal and glossopharyngeal airways were significantly larger than those before treatment,and there was no significant difference between the two groups(P>0.05).The comfort of silensor appliance was significantly better than that of modified activator appliance.Conclusion:Both kinds of oral appliances have good clinical effects on OSAS in the elderly,and silensor adjustable appliances have better comfort.

关 键 词：口腔矫治器 阻塞性睡眠呼吸暂停综合征 老年人 临床疗效 

分 类 号：R782[医药卫生—口腔医学]