热塑成形口腔矫治器治疗阻塞性睡眠呼吸暂停低通气综合征疗效观察  

Immediate intraoral adaptation of mandibular advancing appliances of thermoplastic material for the treatment of obstructive sleep apnea-hypopnea syndrome

作　　者：李玉柱[1] 郝峰英[1] 金桂清[1] 刘又宁[1] 

机构地区：[1]解放军总医院呼吸科,北京100853

出　　处：《中华结核和呼吸杂志》2003年第5期276-278,共3页Chinese Journal of Tuberculosis and Respiratory Diseases

摘　　要：目的　评价热塑成形口腔矫治器治疗阻塞性睡眠呼吸暂停低通气综合征 (OSAHS)的效果。方法　 4 5例经多导睡眠图 (PSG)确诊、并符合治疗条件的OSAHS患者 ,用由加热变性的高分子塑料注塑成形的口腔矫治器治疗 ,对比治疗 4周前、后PSG结果 ,并询问主观症状变化。结果　矫治器治疗的客观有效率为 82 % ,睡眠呼吸暂停低通气指数 (AHI)由 (38± 2 2 )次 /h降至 (11± 9)次 /h ,平均暂停时间由 (2 2± 8)s降至 (15± 11)s,最低血氧饱和度 (SaO2 )由 (72± 11) %提高到 (83± 9) % ,鼾声指数由 (30 4± 10 5 )次 /h降至 (10 8± 113)次 /h ,统计学上差异有非常显著性意义 (P值均 <0 0 0 1)。白天困倦缓解。初用时上下颌肌肉有酸痛感 ,多数患者在 3～ 7d后适应。结论　热塑成形口腔矫治器可以作为内科的一个治疗手段 ,效果肯定 ,而且制作简便 ,患者痛苦小。Objective To appraise the effect of immediate intraoral adaptation of mandibular advancing appliances (MAA) consisting of thermoplastic material for the treatment of obstructive sleep apnea-hypopnea syndrome(OSAHS). Methods 45 patients with OSAHS was treated with MAA that was directly moulded intraorally before sleep. Polysomnography (PSG) was performed and questionnaires recorded prior to and 4 weeks after treatment with MAA. Results The efficiency of MAA for OSAHS was 82%. The medial apnea-hypopnoea index decreased from 38±22 to 11±9 events per hour ( P <0.001); the medial duration of apnea decreased from 22±8 to 15±11 second ( P <0.001); the minimum SaO 2 increased from (72±11)% to (83±9)% ( P <0.001), and the medial snore index decreased from 304±105 to 108±113 events per hour ( P <0.001). The patients′ daytime sleepiness was alleviated, and the majority of the patients could acclimatize themselves to MAA in 3 to 7 days. Conclusions The MAA consisting of thermoplastic material improved OSAHS. It is immediately adaptable and less expensive, and should be considered as a feasible medical treatment.

关 键 词：阻塞性睡眠呼吸暂停 低通气综合征 热塑成形口腔矫治器 治疗 经多导睡眠图 

分 类 号：R56[医药卫生—呼吸系统]