儿童腺样体肥大程度对上气道形态及颌面部骨组织结构的影响  

Influences of adenoid hypertrophy on upper airway morphology and maxillofacial bone structure in children

作　　者：罗甜甜 郭静[2] 王邦耀 孙新新 迪丽努尔·阿卜拉 陈越 刘奕杉[3] LUO Tian-tian;GUO Jing;WANG Bang-yao;SUN Xin-xin;Dilinuer ABULA;CHEN Yue;LIU Yi-shan(Department of Pediatric Stomatology,Stomatology Hospital Affiliated to Southwest Medical University,Luzhou,Sichuan 646099,China;Department of Oral Imaging,the First Affiliated Hospital of Xinjiang Medical University,Stomatology Hospital Affiliated to Xinjiang Medical University,Stomatology Institute of Xinjiang Uygur Autonomous Region,Urumqi,Xinjiang Uygur Autonomous Region 830011,China;Department of Pediatric Stomatology,the First Affiliated Hospital of Xinjiang Medical University,Stomatology Hospital Affiliated to Xinjiang Medical University,Stomatology Institute of Xinjiang Uygur Autonomous Region,Urumqi,Xinjiang Uygur Autonomous Region 830011,China;Department of Orthodontics,the First Affiliated)

机构地区：[1]西南医科大学附属口腔医院儿童口腔科,四川泸州646099 [2]新疆医科大学第一附属医院、新疆医科大学附属口腔医院口腔影像科、新疆维吾尔自治区口腔医学研究所,新疆维吾尔自治区乌鲁木齐830011 [3]新疆医科大学第一附属医院、新疆医科大学附属口腔医院儿童口腔科、新疆维吾尔自治区口腔医学研究所,新疆维吾尔自治区乌鲁木齐830011 [4]新疆医科大学第一附属医院、新疆医科大学附属口腔医院口腔正畸科、新疆维吾尔自治区口腔医学研究所,新疆维吾尔自治区乌鲁木齐830011

出　　处：《中华实用诊断与治疗杂志》2023年第1期74-78,共5页Journal of Chinese Practical Diagnosis and Therapy

摘　　要：目的观察腺样体肥大儿童上气道形态及颌面部骨组织结构变化,探讨腺样体肥大程度与骨性错合畸形的关系。方法腺样体肥大伴张口呼吸患儿108例,均行头颅X线侧位片检查,测量A、N、PNS-UPW、U-MPW、TB-TPPW、V-LPW、∠SNA、∠SNB、∠ANB、∠NP-FH、∠MP-SN、∠FH-MP、∠Y轴、∠U1-SN、∠U1-NA、∠U1-L1、∠L1-NB、∠L1-MP,计算A/N值。依据A/N值,将108例患儿分为生理性肥大组54例(A/N值>0.6~<0.7)和病理性肥大组54例(A/N值≥0.70)。无腺样体肥大及张口呼吸儿童54例为对照组,行头颅X线侧位片检查,测量上述指标。比较3组各测量指标差异,记录骨性错颌畸形发生情况。结果生理性肥大组、病理性肥大组A[(14.62±3.48)、(16.61±4.27)mm]大于对照组[(8.02±2.53)mm](P<0.05),V-MPW[(7.03±2.63)、(6.74±2.47)mm]、PVS-VPW[(16.33±3.91)、(13.49±3.95)mm]均小于对照组[(8.10±2.75)、(21.28±4.58)mm](P<0.05);病理性肥大组A大于生理性肥大组(P<0.05),PVS-VPW小于生理性肥大组(P<0.05),V-MPW与生理性肥大组比较差异均无统计学意义(P>0.05);3组N、TB-TPPW、V-LPW比较差异均无统计学意义(P>0.05)。病理性肥大组∠SNB、∠NP-FH、∠U1-L1均小于对照组(P<0.05),∠ANB、∠MP-SN、∠FH-MP、∠Y轴、∠U1-SN、∠U1-NA、∠L1-MP、∠L1-NB均大于对照组(P<0.05);生理性肥大组∠SNB、∠NP-FH均小于对照组(P<0.05),∠ANB、∠MP-SN、∠Y轴、∠L1-MP均大于对照组(P<0.05);病理性肥大组∠U1-SN、∠U1-NA、∠L1-NB均大于生理性肥大组,∠U1-L1小于生理性肥大组(P<0.05)。生理性肥大组、病理性肥大组Ⅰ类骨性错合畸形发生率(31.48%、24.07%)低于对照组(53.70%)(P<0.05),Ⅱ类骨性错合畸形发生率(46.30%、57.41%)高于对照组(31.48%)(P<0.05);生理性肥大组Ⅱ类骨性错合畸形发生率低于病理性肥大组(P<0.05);3组Ⅲ类骨性错合畸形发生率比较差异无统计学意义(P>0.05)。结论腺样体肥大儿童上气道腭咽、鼻咽段狭窄;病Objective To observe the changes of upper airway morphology and maxillofacial bone structure in children with adenoid hypertrophy,and to explore the relationship between the degree of adenoid hypertrophy and skeletal malocclusion.Methods Totally 108 children with adenoid hypertrophy and mouth breathing received lateral cephalography to measure the anatomical parameters as A,N,PNS-UPW,U-MPW,TB-TPPW,V-LPW,∠SNA,∠SNB,∠ANB,∠NP-FH,∠MP-SN,∠FH-MP,∠Y axis,∠U1-SN,∠U1-NA,∠U1-L1,∠L1-NB and∠L1-MP.The A/N ratio was calculated.According to the A/N value,108children were divided into 54children with A/N>0.6to<0.7(physiological hypertrophy group)and 54children with A/N≥0.70(pathological hypertrophy group).Another 54children with mouth breathing but no adenoid hypertrophy were as controls(control group),and received lateral cephalography to measure the above parameters.All the parameters were compared among three groups,and the occurrence of malocclusion was recorded.Results The value of A was greater in physiological hypertrophyc2z group[(14.62±3.48)mm]and pathological hypertrophy group[(16.61±4.27)mm]than that in control group[(8.02±2.53)mm](P<0.05),and greater in pathological hypertrophy group than that in physiological hypertrophy group(P<0.05).The values of V-MPW and PVS-VPW were smaller in physiological hypertrophy group[(7.03±2.63),(16.33±3.91)mm]than those in pathological hypertrophy group[(6.74±2.47),(13.49±3.95)mm]than those in control group[(8.10±2.75),(21.28±4.58)mm](P<0.05).PVS-VPW was smaller in pathological hypertrophy group than that in physiological hypertrophy group(P<0.05),and V-MPW showed no significant difference between two groups(P>0.05).There were no significant differences in N,TB-TPPW and V-LPW among three groups(P>0.05).∠SNB,∠NP-FH and∠U1-L1were smaller in pathological hypertrophy group than those in control group(P<0.05),and∠ANB,∠MP-SN,∠FH-MP,∠Y axis,∠U1-SN,∠U1-NA,∠L1-MP and∠L1-NB were larger in pathological hypertrophy group than those in control

关 键 词：腺样体肥大 上气道形态 颌面部骨组织 张口呼吸 

分 类 号：R766[医药卫生—耳鼻咽喉科]