改良功能矫治器治疗儿童阻塞性睡眠呼吸暂停低通气综合征的疗效及气道变化

Effect of Improved Functional Appliance on treatment of Obstructive Sleep Apnea Hypopnea Syndrome and Airway Changes in Children

目的观察改良双合垫矫治器(TBA)治疗儿童阻塞性睡眠呼吸暂停低通气综合征(OSAHS)的疗效及气道变化。方法下颌骨后缩合并OSAHS患儿25例,用改良TBA治疗,治疗前后采用多导睡眠监测血氧饱和度(SaO2)、睡眠呼吸暂停低通气指数(AHI),并通过锥体束CT(CBCT)三维重建分析上气道大小形态的改变。结果治疗后V总-口咽气道总体积、Amin-气道最小截面面积、L矢-最小截面矢状径、L横-最小截面横径、L矢/L横-最小截面矢状径/横径、SaO2均明显大于治疗前(P<0.05),AHI明显低于治疗前(P<0.05)。结论下颌后缩合并OSAHS儿童,采用改良式TBA治疗后,气道矢状、横向宽度增加,明显改善通气。

Objective To observe the effect of improved twin-block applicance（ TBA） on the treatment of obstructive sleep apnea hypopnea syndrome（ OSAHS） and airway changes in children. Methods Twenty-five OSAHS children with mandibular deficiency were treated with improved TBA. Oxygen saturation（ SaO2）,apnea-hypopnea index（ AHI）were monitored by polysomnography before and after treatment. Three-dimensional cone beam computed tomography（ CBCT） reconstruction was used to analyze the morphological changes of the upper airway. Results After treatment,the patients＇ volume and area of the upper airway increased significantly（ P 〈 0. 05）,SaO2 increased but AHI reduced（ P 〈 0.05）. Conclusion The improved TBA applied to treatment of OSAHS children with mandibular deficiency can increase the shape and size of the airway and improve the airway ventilation effectively.