MASSD治疗OSAHS临床疗效研究及便携式下颌前伸定位器研制

发布时间：2018-05-05 12:59

  本文选题：阻塞性睡眠呼吸暂停低通气综合征 + 下颌前伸止鼾器　； 参考：《昆明医科大学》2017年硕士论文

【摘要】：[目的]使用下颌前伸止鼾器(MASSD)治疗轻、中度OSAHS患者,对其术前、术后多导睡眠监测(PSG)、柏林问卷(BQ)、嗜睡量表(ESS)、舒适度问卷表进行对比研究,评价MASSD治疗OSAHS临床疗效;对传统下颌前伸定位在临床应用中的不足,研制便携式下颌前伸定位器。[方法]1.研究纳入30例轻、中度OSAHS患者。使用MASSD治疗OSAHS,并进行术前、术后6个月临床对比研究。客观疗效观察指标为PSG监测指标:呼吸暂停指数(AHI)、鼾声次数、最低血氧饱和度(LSa02);主观疗效观察指标:柏林问卷(BQ)、嗜睡量表(ESS)、舒适度问卷调查表。对各项观察指标数据采用SPSS21.0软件包进行自身配对t检验。2.探讨目前常见的几种下颌前伸定位方法的不足,联合昆明理工大学和上海IIBM公司,对步进电机、步进电机驱动器、电源、蓝牙模块、安卓系统智能手机、血氧饱和仪等装置进行改装和编写程序,完成便携式下颌前伸定位器制作,根据患者主观感受和监测数据,计算机辅助确定下颌前伸距离,实现“个性化”下颌前伸距离的调节,提高治疗效果及舒适度。[结果]1.30例轻、中度OSAHS患者戴用下颌前伸止鼾器,经6个月随访观察,客观结果显示:治疗后平均AHI指数降为(10.24±4.25)次/h;最低血氧饱和度(Lsao2)显著提高,均≥91 %。经统计学分析,疗效肯定(P0.05)。因鼾声次数不服从正态分布,结果以P50 (P25,P75)表示,治疗前后差异用秩和检验0.001。主观问卷调查结果显示:本实验30例患者戴用止鼾器后其中27例脱离呼吸暂停风险,3例患者虽然没有脱离呼吸暂停风险,但有所缓解;30例患者中较舒适12例,占40%、舒适13例,占43.33%、不适患者3例,占10%、明显不适患者2例,占6.67%,患者术后主要会有牙齿酸痛、口干、早晨起床后咬合不适、唾液增多、脸颊、关节区酸胀等不适症状,5例不适患者经下颌前伸距离调改后,舒适度提高,全都愿意佩戴止鼾器。2.完成自制便携式下颌前伸定位器。[结论]1. MASSD是治疗轻、中度阻塞性呼吸暂停低通气综合征(OSAHS)的有效方法。2.下颌前伸量大小与下颌前伸止鼾器的疗效密切相关,前伸量过小达不到治效果,过大会导致患者不适甚至产生副作用,说明MASSD行下颌前伸精确定位需要进一步研究。3.自制便携式下颌前伸定位器实现“个性化”.下颌前伸距离的调节,提高疗效及舒适度。有望在临床上得到推广应用。
[Abstract]:[objective] to evaluate the clinical efficacy of MASSD in the treatment of mild and moderate OSAHS patients with mild and moderate OSAHS by using mandibular protruding and snoring arrester (MASSD). The results were compared with those of polysomnography, Berlin questionnaire, somnolence scale and comfort scale before and after operation. A portable mandibular protruding locator was developed for the deficiency of traditional mandibular protruding localization in clinical application. [methods] 1. The study included 30 mild and moderate OSAHS patients. MASSD was used in the treatment of OSAHS, and a comparative clinical study was carried out 6 months before and 6 months after operation. The objective curative effect indexes were as follows: apnea index: apnea index, snoring frequency, lowest blood oxygen saturation, LSa02a, subjective efficacy observation index: Berlin questionnaire, somnolence scale, and comfort questionnaire. SPSS21.0 software package was used to carry out self-paired t test. 2. 2. This paper discusses the shortcomings of several common methods of mandibular protruding positioning, combines Kunming University of Technology and Shanghai IIBM Company, compares stepping motor, stepper motor driver, power supply, Bluetooth module, Android smart phone, etc. The device such as blood oxygen saturation instrument was modified and programmed to make the portable mandibular protruding positioner. According to the patient's subjective feeling and monitoring data, the distance of mandibular protruding was determined by computer. The adjustment of mandibular protruding distance can be realized, and the therapeutic effect and comfort can be improved. [results] 1.Thirty patients with mild and moderate OSAHS wore mandibular protruding snoring apparatus. After 6 months follow-up observation, the objective results showed that the average AHI index decreased to 10.24 卤4.25 times / h after treatment, and the lowest oxygen saturation (Lsao2) increased significantly (all 鈮，

本文编号：1847776