一种可调型下颌前移矫治器治疗OSAS患者的临床应用

Clinical application of a modified appliance in treatanent of Obstructive Sleep Apnea Syndrome after UPPP

目的观察一种可调节的下颌前移矫治器治疗阻塞性睡眠呼吸暂停综合征的情况并评价其临床疗效。方法6名UPPP手术效果不佳的OSAS患者戴用矫治器,治疗前后进行多导睡眠仪监测和X线头影测量。结果患者戴用矫治器感觉舒适并自觉戴用。使用该矫治器一个月后,患者的主观症状明显改善,AI、AHI均明显降低(P<0.01),SaO2明显上升(P<0.01)。X线片显示下颌前移(P<0.05)、气道增宽(P<0.05)、软腭和舌体缩短(P<0.05)、舌骨上移(P<0.01)。结论该下颌前移矫治器的设计针对个体,极易调改、轻便舒适、应用灵活,因此疗效好,且制作简单,适于临床推广应用。

Objective To evaluate the treatment effects of an adjustive mandibular advancement appliance in patients with obstructive sleep apnea sydrome (OSAS) . Method 6 OSAS patients from failing UPPP surgery wore the appliance. Polysomnographic monitoring and cephalometric analysis were performed before and after treatment to analyze the effect of the appliance. Results Patients felt comfort with the appliance and wore it consciously. With the appliance on after a month, patients felt better, and the values of AI, AHI decreased significantly (P<0.01,P<0.05), the lowest Sa02 increased significantly ( P < 0.01) . Cephalometric analysis showed the forward movement( P < 0.05 ) , the widened airway (P < 0.05 ) , shortened soft palate and tongue (P < 0.05 ) and the upper position of hyoid bone ( P < 0.01)after treatment.Conclusion The mandibular advancement appliance is designed to adapt to individual situation. It is portable, comfortable, and easy to be modified with good effect and simple application, the adjustive appliance is a good option in treatment of OSAS.