口面肌功能训练对成人重度阻塞性睡眠呼吸暂停上气道术后疗效的影响  

Effects of orofacial myofunctional therapy on postoperative outcomes of upper airway surgery for adults with severe obstructive sleep apnea

作　　者：吴楚城 卢镇章 陈李清 聂国辉[1] 卢永田[1] 陶晶[1] WU Chucheng;LU Zhenzhang;CHEN Liqing;NIE Guohui;LU Yongtian;TAO Jing(Department of Otorhinolaryngology Head and Neck Surgery,the Second Hosipital of Shenzhen,Shenzhen,518000,China;Department of Otorhinolaryngology Head and Neck Surgery,South China Hospital of Shenzhen University;Department of Otorhinolaryngology Head and Neck Surgery,Shenzhen University General Hospital)

机构地区：[1]深圳市第二人民医院耳鼻咽喉头颈外科,广东深圳518000 [2]深圳大学附属华南医院耳鼻咽喉头颈外科 [3]深圳大学总医院耳鼻咽喉头颈外科

出　　处：《临床耳鼻咽喉头颈外科杂志》2022年第12期916-920,共5页Journal of Clinical Otorhinolaryngology Head And Neck Surgery

基　　金：2021年深圳市第二人民医院院内临床资助项目(No:20213357025)。

摘　　要：目的:探讨口面肌功能训练对成人重度阻塞性睡眠呼吸暂停(OSA)患者上气道手术临床疗效的影响。方法:纳入2020年6月—2021年9月于深圳市第二人民医院行上气道手术的OSA患者48例,随机分为联合组(21例)和单纯手术组(27例),联合组在上气道手术后1个月开始行口面肌功能训练,单纯手术组不进行口咽肌功能训练,通过对比分析2组有效率,术后6个月的呼吸暂停低通气指数(AHI)、最低血氧饱和度(LSaO_(2))、鼾声事件及Epworth嗜睡量表评分等情况。结果:联合组术后6个月AHI、LSaO2、鼾声事件、总鼾声时间占比分别为(14.77±9.15)次/h、(81.19±6.52)%、(172.43±73.67)次、(13.16±6.02)%、单纯手术组术后6个月AHI、LSaO_(2)、鼾声事件、总鼾声时间占比为(23.87±10.60)次/h、(80.78±4.88)%、(235.81±83.23)次、(17.58±5.94)%,两组患者术后6个月较术前比较,AHI、鼾声事件、总鼾声时间占比明显下降,LSaO2明显提高,差异均有统计学意义(P<0.05),但联合组术后6个月AHI、鼾声事件、总鼾声时间占比改善较单纯手术组明显,差异均有统计学意义(P<0.05)。结论:口面肌功能训练可以提高成人重度OSA上气道手术术后临床疗效。Objective: To investigate the effect of orofacial myofunctional therapy on the clinical efficacy of upper airway surgery for adults with severe obstructive sleep apnea(OSA). Methods: A total of 48 patients with OSA who underwent upper airway surgery in the Shenzhen Second People’s Hospital from June 2020 to September 2021 were included in this study. These patients were randomly divided into the combination group(21 cases) and the surgery group(27 cases). The effective rate, AHI, minimum blood oxygen saturation, snoring events and Epworth sleepiness scale scores at 6 months after operation were compared and analyzed between the two groups. Results: The proportions of AHI, LSaO_(2), snoring events, and total snoring time in the combined group at 6 months after operation were(14.77±9.15) times/h,(81.19±6.52)%,(172.43±73.67) times, and(13.16±6.02)%. The proportion of AHI, LSaO_(2), snoring events, and total snoring time in surgical group at 6 months after operation was(23.87±10.6) times/h,(80.78±4.88)%,(235.81±83.23) times,(17.58±5.94)%. Compared with preoperative 6 months after operation, the proportion of AHI, snoring events, and total snoring time was significantly decreased, and LSaO2was significantly increased, and the differences were statistically significant(P<0.05). The time of snoring and the proportion of snoring to time were significantly improved compared with those in the simple operation group, and the differences were statistically significant(P<0.05). Conclusion: This study verified that orofacial myofunctional therapy can improve the clinical efficacy after upper airway surgery for adults with severe obstructive sleep apnea.

关 键 词：阻塞性睡眠呼吸暂停 口面肌功能训练 外科手术 

分 类 号：R766[医药卫生—耳鼻咽喉科]