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目的:探讨可调节型阻鼾器治疗成人OSAHS的临床疗效并观察上气道改变及对颞颌关节的影响。方法:多导睡眠监测(PSG)确诊的40例成人OSAHS患者,使用可调节型阻鼾器治疗6个月后采用PSG评估睡眠呼吸暂停低通气指数(AHI)、最低血氧饱和度(LSaO2),并通过锥体束CT(CBCT)三维重建分析上气道大小形态的改变,初步观察颞颌关节前后隙的变化。结果:治疗后PSG结果显示,LSaO2均明显大于治疗前(P<0.01),AHI明显低于治疗前(P<0.01)。CBCT分析示口咽气道总容积、气道最小横截面积、最小矢状径、最小横径均明显大于治疗前(P<0.01)。颞下颌关节髁状突运动位置并未超过术前最大开口位生理运动范围,髁状突表面皮质骨形态与连续性未发现明显异常。结论:成人OSAHS采用可调节型阻鼾器治疗后,气道容积、横截面积、矢状及横向宽度增加,改善了通气,在保持舒适度的同时减少了对颞颌关节的影响,且初步观察未对颞下颌关节产生影响。
Objective: To investigate the curative effect of adjustable snorers on adult OSAHS and observe the effects of upper airway changes and temporomandibular joint. METHODS: Forty adults with OSAHS diagnosed by polysomnography (PSG) were assessed with PSG for sleep apnea-hypopnea index (AHI), minimum oxygen saturation (LSaO2) , And the changes of upper airway size and shape were analyzed by pyramidal tract computed tomography (CBCT) three-dimensional reconstruction. The changes of temporomandibular joint anterior and posterior space were initially observed. Results: After treatment, PSG results showed that LSaO2 was significantly greater than before treatment (P <0.01), AHI was significantly lower than before treatment (P <0.01). CBCT analysis showed that total pharyngeal airway volume, minimum cross-sectional area of airway, minimum sagittal diameter and minimum transverse diameter were significantly larger than those before treatment (P <0.01). The temporomandibular joint condylar movement did not exceed the maximum preoperative physiological range of motion, condylar surface cortical bone morphology and continuity were not found abnormalities. CONCLUSIONS: Adult OSAHS can improve airway volume, cross-sectional area, sagittal and lateral width after adjusting type snorer, which can reduce the impact on temporomandibular joint while maintaining comfort, and preliminary The observation did not affect the temporomandibular joint.