2种下颌前移器治疗重度睡眠呼吸暂停低通气综合征患者的疗效评价

发布时间：2018-07-08 10:07

本文选题：阻塞性睡眠呼吸暂停低通气综合征 + 下颌前移器　；参考：《上海口腔医学》2014年06期

【摘要】：目的:探讨拒绝持续正压通气(continuous positive airway pressure,CPAP)或不耐受CPAP治疗的重度阻塞性睡眠呼吸暂停低通气综合征(obstructive sleep apnea hypopnea syndrome,OSAHS)患者,采用2种下颌前移器分别干预治疗6周的效果。方法:采用随机交叉试验,22例男性重度OSAHS患者,分别辅以2种下颌前移器(mandibular advancement devices,MADs)干预治疗(拉杆式和可控式),试验周期为14周,每种戴用6周,间隔停用2周,分析2种下颌前移器干预前与戴用6周的多导睡眠图监测(polysomnography,PSG)指标间差异,同时进行问卷调查(Epworth嗜睡量表、SCL-90症状自评量表),并评估下颌前移器的固位性、不良反应及主观症状等参数。采用SPSS19.0软件包对数据进行统计学分析。结果:与干预治疗前呼吸暂停低通气指数AHI(48.16±13.99次/h)相比,拉杆式前移器组AHI(19.16±2.74次/h)、可控式前移器组AHI(18.93±2.57次/h)均较干预前下降50%。其余指标表明,2种前移器均具有显著疗效(P0.01),SCL-90各项因子指标均有不同程度下降。躯体化、人际敏感、焦虑与干预前相比,差异具有统计学意义(P0.05)。代表依从性的固位情况和咬合舒适性指标,2组之间差异显著(P均0.05)。结论:2种下颌前移器不仅客观疗效明显,同时有助患者身心健康。在依从性方面,可控式前移器具有明显优势,但长期影响需进一步研究。
[Abstract]:Objective: To investigate the effect of 2 types of obstructive sleep apnea hypopnea syndrome, OSAHS) in patients with severe obstructive sleep apnea hypopnea syndrome (obstructive sleep apnea hypopnea) treated by continuous positive airway pressure (CPAP) or intolerance of CPAP. Methods: a randomized cross test was used. 22 patients with severe OSAHS were treated with 2 kinds of mandibular advancement devices (MADs) intervention treatment (pull rod type and controllable type), the test period was 14 weeks, each kind of wear was used for 6 weeks, and the interval was discontinued for 2 weeks. The difference between the 2 kinds of mandibular anterior shift intervention and the 6 weeks polysomnography monitoring (polysomnography, PSG) was analyzed before the intervention of the 2 kinds of mandibular forwards. At the same time, a questionnaire survey (Epworth somnolence scale, SCL-90 symptom checklist) was used to evaluate the retention, adverse reactions and subjective symptoms of the mandibular forwards. The data were statistically analyzed by SPSS19.0 software. Results: compared with the low ventilation index AHI (48.16 + 13.99 times /h) before the intervention treatment, the pull rod type forward device was used. Group AHI (19.16 + 2.74 times /h), the AHI (18.93 + 2.57 times /h) of the controlled anterior shift group were all compared with the other indexes of 50%. before the intervention, indicating that all the 2 kinds of forwards had significant curative effect (P0.01), and all the factors of SCL-90 were decreased in varying degrees. The differences were statistically significant compared with those before the intervention (P0.05). There was a significant difference between the 2 groups (P 0.05). Conclusion: the 2 kinds of mandibular prefixer not only have obvious objective effect, but also help the patients' physical and mental health. In compliance, the controllable preshift has obvious advantages, but the long-term effect should be further studied.
【作者单位】：合肥市口腔医院口腔正畸科;安徽医科大学第一附属医院耳鼻咽喉头颈外科;
【基金】：合肥市2010年度第一批科技计划项目(074)~~
【分类号】：R783.5;R766

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