中国实用口腔科杂志

中国实用口腔科杂志

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口腔功能性矫治器治疗青春期下颌后缩伴阻塞性睡眠呼吸暂停低通气综合征19例追踪研究

  

  1. 1.焦作市第二人民医院，河南  焦作  454000；2. 焦作市安康医院，河南  焦作  454001
  • 收稿日期:2012-12-17 修回日期:2013-05-17 出版日期:2013-08-15 发布日期:2013-09-29

  • Received:2012-12-17 Revised:2013-05-17 Online:2013-08-15 Published:2013-09-29

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摘要：

目的    探讨口腔功能性矫治器治疗青春期下颌后缩伴阻塞性睡眠呼吸暂停低通气综合征（OSAHS）的远期疗效。方法    选择2003年4月至2005年10月焦作市第二人民医院收治的下颌发育后缩合并OSAHS的患儿19例，戴用口腔功能性矫治器进行治疗，分别在治疗前、治疗结束时、治疗后5年拍摄X线头颅侧位片和进行多导睡眠监测，比较睡眠呼吸暂停低通气指数（AHI）、夜间最低血氧饱和度（SaO2）和X线头影测量指标的变化。结果        治疗后患儿均诉鼾声减小或消失，未见睡眠中憋气，日间困倦缓解或消失。治疗结束时SNA角无明显改善，SNB角明显增大，LL-H线距明显减小，且SNA角与SNB角相差较大的OSAHS患儿治疗效果更好；治疗结束后追踪随访5年发现，SNA角、SNB角、LL-H线距、夜间最低SaO2及AHI均无明显改变。结论    口腔功能性矫治器治疗青春期下颌后缩伴OSAHS远期疗效稳定，具有无创伤、安全、、痛苦小、效果稳定的优点。

关键词: 功能性矫治器, 阻塞性睡眠呼吸暂停, 青少年, X线头影测量

Abstract:

Objective    To discusses the long term curative effect in curing the adolescent's mandibular retraction accompanied by Obstructive sleep apnea-hypopnea syndrome （OSAHA） using oral functional appliance. Methods    Totally 17 adolescent patients previously studied were included in the treatment，in which they were given two medical measurements including polysomnography（PSG）and X-ray cephalometry. These measurements were used in the comparison of current Apnea-Hypopnea Index （AHI），lowest Oxygen Saturation （SaO2） at night and variation of X-ray cephalometry with the corresponding factors recoded five years ago. Results    After treatment， all children's feeling of tirednessand snoring remarkably reduced or disappeared，none of them woke up from sleep，and daytime sleepiness remitted or disappeared. When the treatment was finished，SNA angle improved little，SNB angle increased remarkably，LL-H distance reduced obviously， and the curative effect for the OSAHS children was better in those whose SNA angles had a big difference from their SNB angles. After the treatment was finished they were given 5 years'follow-up，and we found that SNA angle， SNB angle， LL-H both distance，the lowest SaO2 at night and AHI didn't change obviously. Conclusion    Treatment for the adolescent's OSAHA accompanied by mandibular retraction using oral functional appliance is effective in the long term，with the advantages of being of no damage，safety，inexpensive cost，less agony and stable curative effect.

Key words: functional appliance, obstructive sleep apnea-hypopnea, children, X-ray cephalometry