肌功能训练联合咬合诱导器治疗OSA儿童牙列不齐的临床疗效  

The efficacy of muscle function training combined with occlusal inducer in the treatment of malocclusion in children with OSA

作　　者：辛渊[1] 陈洁[1] 孙培音 XIN Yuan;CHEN Jie;SUN Peiyin(Department of Otorhinolaryngology Oral and Maxillofacial Surgery,Shanghai Children's Medical Center,School of Medicine,Shanghai Jiao Tong University,Shanghai,200127,China)

机构地区：[1]上海交通大学医学院附属上海儿童医学中心耳鼻喉口腔颌面外科,上海200127

出　　处：《临床耳鼻咽喉头颈外科杂志》2023年第8期642-647,共6页Journal of Clinical Otorhinolaryngology Head And Neck Surgery

基　　金：上海市卫生健康委员会上海市综合医院中西医结合专项(No:ZHYY-ZXYJHZX-202009)。

摘　　要：目的:探讨肌功能训练联合咬合诱导器在阻塞性睡眠呼吸暂停(obstructive sleep apnea, OSA)儿童术后牙列不齐治疗中的临床效果。方法:选取2020年1月-2021年12月就诊于上海交通大学医学院附属上海儿童医学中心耳鼻喉口腔颌面外科OSA术后40例患儿,分为治疗组(20例)和对照组(20例),治疗组通过肌功能训练联合咬合诱导器,对照组仅行肌功能训练。比较两组头影测量硬组织术前、术后12个月的数值变化及术前、术后6、12个月儿童阻塞性睡眠呼吸暂停18项生活质量调查表(OSA-18)评分。结果:(1)两组患者术后12个月睡眠障碍、身体症状、情绪状况、白天嗜睡和精力状态及对监护人的影响程度均得到明显改善(P<0.05),治疗组在睡眠障碍、身体症状、情绪状况、对监护人的影响程度的评分优于对照组(P<0.05);(2)术后12个月头影测量数据显示:治疗组术后12个月的上下齿槽座角(ANB)、覆[牙合](overbite)、上下中切牙角(U1-L1)、覆盖(overjet),与对照组比较有所减小,差异有统计学意义(P<0.05)。结论:儿童OSA患者术后可通过肌功能训练联合咬合诱导器改善牙列不齐,其效果优于单纯肌功能训练。Objective This study aims to investigate the clinical effectiveness of muscle function training combined with occlusal inducers in the treatment for children's malocclusion after obstructive sleep apnea(OSA)surgery.Methods A total of 40 pediatric patients who underwent surgery for OSA at Shanghai Children's Medical Center,affiliated with Shanghai Jiao Tong University School of Medicine,from January 2020 to December 2021 were involved in this study.They were divided into a treatment group(n=20)and a control group(n=20).The treatment group received muscle function training combined with occlusal inducers,while the control group received muscle function training alone.Cephalometric measurements of hard tissues were compared between the two groups before and 12 months after surgery.Additionally,the OSA-18 questionnaire,which includes 18 items to assess the life quality of children with OSA,was filled out before surgery,6 months after surgery,and 12 months after surgery by these patients.Results①The scores of sleep disorders,physical symptoms,emotional status,daytime sleepiness and energy status and the degree of influence on guardians in the two groups were significantly improved at 12 months after operation(P<0.05).The scores of sleep disorders,physical symptoms,emotional status and the degree of influence on guardians in the treatment group were better than those in the control group(P<0.05).②Cephalometric data at 12 months after operation showed that the upper and lower alveolar seat angle(ANB),Overbite,upper and lower central incisor angle(U1-L1)and Overjet in the treatment group were lower than those in the control group at 12 months after operation,and the difference was statistically significant(P<0.05).Conclusion Children with OSA can improve the dentition irregularity by muscle function training combined with occlusal inducer after operation,and the effect is better than that of muscle function training alone.

关 键 词：肌功能训练 咬合诱导器 阻塞性睡眠呼吸暂停 牙列不齐 

分 类 号：R766[医药卫生—耳鼻咽喉科]