口腔矫治器治疗阻塞性睡眠呼吸暂停低通气综合征——计算机辅助下颌前伸定位

A study on treatment of patients with obstructive sleep apnea/hypopnea syndrome by computer aided mandibular repositioning and polysomnography

目的：评价计算机辅助下颌前伸定位系统（CAMRS）用于提高口腔矫治器治疗阻塞性睡眠呼吸暂停低通气综合征（OSAHS）疗效的临床实效性。方法：采用交叉试验设计对11例男性OSAHS患者先后夜间戴用“经验式”口腔矫治器（凭经验确定下颌前伸量）和“测定式”口腔矫治器（由CAMRS确定下颌前伸量）治疗各1个月，分析比较2种口腔矫治器的主、客观疗效及下颌前伸量，以检验CAMRS的有效性和临床实用性。结果：2种方法确定的平均下颌前伸量无显著性差异（P〉0．05），但是CAMRS测定的最适下颌前伸量个体间变异大，变异范围为最大前伸量的33％～100％。“测定式”口腔矫治器治疗OSAHS的疗效优于“经验式”口腔矫治器（P〈0．01）。结论：计算机辅助下颌前伸定位系统的临床应用，能够为OSAHS患者接受口腔矫治器治疗时提供个体化的最适下颌前伸位，提高了疗效。

Objective：To evaluate the effects of the computer aided mandibular repositioning system （CAMRS） in improving the efficacy of oral appliance for treatment of obstructive sleep apnea/hypopnea syndrome （OSAHS）. Methods：A cross-over design trial was carried out on 11 male patients with OSAHS. The experience-oriented oral appliance and the titration-oriented oral appliance were employed to treat patients for three months respectively. The effectiveness of CAMRS was evaluated on the basis of comparison between these two oral appliances. Results ：There was no significant difference between the average mandibular protraction of the experience- oriented and the titration-oriented oral appliances（P 〉 0.05 ）. The optimal advancement of CAMRS had a great variance from 33% to 100% of the maximum tolerable protraction among those patients. The titration-oriented oral appliance showed significantly better efficacy than the experience-oriented oral appliance （P 〈 0.01 ）. Conclusion：Clinical application of CAMRS may provide an individualized optimal mandibular advancement for each OSAHS patient. It can improve the efficacy and the compliance of the oral appliance for treatment of OSAHS patients.