口腔医学研究

口腔医学研究 ›› 2016, Vol. 32 ›› Issue (7): 737-741.DOI: 10.13701/j.cnki.kqyxyj.2016.07.018

• 临床研究论著 • 上一篇    下一篇

下颌前伸式阻鼾器的改良及对轻中度OSA的临床疗效评价

徐超1, 秦猛1*, 何健民1, 王俊莱1, 谢宇平2, 康宏3, 马薇2, 惠培林2   

  1. 1. 甘肃省人民医院口腔修复科 甘肃 兰州 730000;
    2. 甘肃省人民医院睡眠医学中心 甘肃 兰州 730000;
    3. 兰州大学口腔医院修复科 甘肃 兰州 730000
  • 收稿日期:2015-11-02 出版日期:2016-07-26 发布日期:2016-07-25
  • 通讯作者: 秦猛,E-mail:269158531@qq.com
  • 作者简介:徐超(1984~ ),女,四川人,硕士,主治医师,主要从事口腔科的临床治疗工作。
  • 基金资助:
    甘肃省技术研究与开发专项计划(1305TCYA031);甘肃省卫生行业科研计划(GSWSKY2014-56)

Clinical Effect of Improved Mandibular Advancement Appliance on the OSA.

XU Chao1, QIN Meng1*, HE Jian-min1, WANG Jun-lai1, XIE Yu-ping2, KANG Hong3, MA Wei2, HUI Pei-lin2.   

  1. 1. Department of Prosthodontics, Gansu Provincial People's Hospital, Lanzhou 730000, China;
    2. The Sleep Medicine Center, Gansu Provincial People's Hospital, Lanzhou 730000, China;
    3. Department of Prosthodontics, Stomatology School of Lanzhou University, Lanzhou 730000, China
  • Received:2015-11-02 Online:2016-07-26 Published:2016-07-25

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摘要： 目的: 对临床常用的胶联一体下颌前伸式阻鼾器进行改良,评价其对轻、中度阻塞型睡眠呼吸暂停综合征(OSA)的临床疗效。方法: 40例经多导睡眠呼吸监测(PSG)确诊为轻、中度OSA(5＜AHI＜30)的患者,随机将其均分为实验组及对照组,分别佩戴改良一体式阻鼾器和软压膜一体式阻鼾器,佩戴前及3月后行个人问卷调查及PSG监测,分别记录患者主观症状及睡眠参数变化,比较两组治疗前、后情况差异。结果: 与治疗前比较, 实验组18例的AHI下降了50%以上,客观有效率为90%,高于对照组55%;实验组治疗后N1%显著减少、N2%和N3%显著增加(P<0.05),对照组治疗前、后睡眠结构没有明显改善。实验组主观症状改善率高于对照组,无睡眠中阻鼾器脱落现象发生。结论: 改良一体式阻鼾器对于轻、中度OSA有更好的治疗效果,在OSA的治疗中有广阔的临床应用价值。

关键词: 睡眠呼吸暂停低通气综合征, 阻塞型, 改良一体式阻鼾器, 多导睡眠呼吸监测

Abstract: Objective: To improve the constructure of the common mandibular advancement appliance and evaluate the clinical effect of the modified oral appliance on the treatment of mild to moderate OSA. Methods: Forty patients with mild to moderate OSA(5＜AHI＜30) diagnosed by polysomnography (PSG) were included in the study. All subjects were divided into the experimental group and the control group randomly. The PSG was monitored for all subjects before and after 3 months treatment respectively. The diversity was calculated between two groups on the basis of the AHI, LSaO2, and sleep structures recorded by PSG. At the same time, the subjective symptom was collected by questionnaire. Results: Compared to pretreatment, 40 patients responded to the appliance therapy. Apnea hypopnea index in 18 patients of the experimental group was reduced by 50%, the efficiency was 90%, significantly higher than the control group. Lowest arterial oxygen saturation improved significantly in two groups (P<0.05) . The N1% was shorter and the N2% and N3% were longer compared with preoperative status in the experimental group (P<0.05). Disordered sleep patterns in the control group improved not obviously. Falling of snore guards didn't occur in the experimental group. Conclusion: Modified oral appliance is more effective in the treatment of mild to moderate OSA than traditional mandibular advancement appliance.

Key words: Sleep apnoea hypopnea syndrome, Obstructive , Modified oral appliance, Polysomnography.

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