阻塞性睡眠呼吸暂停低通气综合征患儿颌骨发育异常情况及其影响因素、对策分析  

Analysis of abnormal jaw development in children with obstructive sleep apnea hypopnea syndrome and its influencing factors and countermeasures

作　　者：钟冠忠 吴莉 黄翠仪 黄斌 唐智 ZHONG Guan-zhong;WU Li;HUANG Cui-yi(Department of Otolaryngology,Xingtan Hospital Affiliated to Shunde Hospital of Southern Medical University,Foshan 528325,China)

机构地区：[1]南方医科大学顺德医院附属杏坛医院耳鼻咽喉科,528325

出　　处：《中国实用医药》2024年第12期51-54,共4页China Practical Medicine

基　　金：佛山市卫生健康局医学科研课题立项(项目编号:20220045)。

摘　　要：目的研究阻塞性睡眠呼吸暂停低通气综合征(OSAHS)患儿颌骨发育异常情况及其影响因素和对策。方法98例OSAHS患儿,根据是否发生颌骨发育异常分为观察组(49例)和对照组(49例)。所有患儿均以医用数字化X线摄影术(DR)行头影测量和颌骨DR影像测量:X线头影测量后气道间隙(PAS),反映上颌突度的SNA角和反映下颌突度的SNB角,上颌骨宽度以及下颌骨长度、宽度、高度。比较两组患儿颌面部测量指标,分析患儿SNA、SNB、PAS与呼吸暂停低通气指数(AHI)、最低血氧饱和度(LSaO_(2))的相关性。结果两组患儿上颌骨宽度、下颌骨长度、下颌骨宽度、下颌骨高度比较,无统计学差异(P>0.05)。与对照组患儿SNA(81.31±2.52)°、SNB(82.53±2.34)°、PAS(6.35±2.12)mm相比,观察组患儿的(82.34±2.45)°、(83.83±3.17)°、(11.13±2.35)mm更高,差异有统计学意义(P<0.05)。将独立样本t检验中差异有统计学意义的项目分别与AHI、LSaO_(2)做相关性分析,结果发现,SNA与AHI呈负相关,SNA与LSaO_(2)以及SNB、PAS与AHI、LSaO_(2)均呈正相关,SNB、PAS与LSaO_(2)呈负相关(P<0.05)。结论对于OSAHS患儿SNA、SNB、PAS水平均与AHI、LSaO_(2)显著相关,在一定程度上影响儿童早期颌骨发育,应及时发现,及时干预。Objective To study the abnormal jaw development in children with obstructive sleep apnea hypopnea syndrome(OSAHS)and its influencing factors and countermeasures.Methods A total of 98 children with OSAHS were divided into an observation group(49 cases)and a control group(49 cases)according to whether there was abnormal jaw development.All the patients were measured by medical digital radiography(DR)and jaw DR imaging:X-ray cephalometric measurements of posterior airway space(PAS),SNA angle reflecting maxillary protuberance and SNB angle reflecting mandibular protuberance,maxillary width,and mandibular length,width,and height.The maxillofacial measurement indexes of the two groups were compared,and the correlation of SNA,SNB,PAS with apnea hypopnea index(AHI)and lowest blood oxygen saturation(LSaO_(2))was analyzed.Results There were no significant differences in maxillary width,mandibular length,mandibular width and mandibular height between the two groups(P>0.05).The observation group had SNA of(82.34±2.45)°,SNB of(83.83±3.17)°and PAS of(11.13±2.35)mm,which was statistically significant from(81.31±2.52)°,(82.53±2.34)°and(6.35±2.12)mm in the control group(P<0.05).The items with statistically significant differences in the t test of independent samples were correlated with AHI and LSaO_(2) respectively.The results showed that SNA was negatively correlated with AHI,SNA was positively correlated with LSaO_(2),SNB and PAS were positively correlated with AHI,and SMB and PAS were negatively correlated with LSaO_(2)(P<0.05).Conclusion For children with OSAHS,SNA,SNB and PAS levels are significantly correlated with AHI and LSaO_(2),which affect the early jaw development of children to a certain extent,and should be detected and intervened in a timely manner.

关 键 词：阻塞性睡眠呼吸暂停低通气综合征 颌骨发育异常 影响因素 对策 

分 类 号：R766[医药卫生—耳鼻咽喉科]