双(牙合)板矫治器治疗阻塞性睡眠呼吸暂停综合征的研究

目的介绍一种上下颌分体式的双(牙合)板矫治器,探讨应用该矫治器治疗阻塞性睡眠呼吸暂停综合征(OSAS)的效果.方法为 29 例 OSAS 患者制作双(牙合)板矫治器,戴用矫治器前后进行多导睡眠监测对比疗效;治疗前后进行标准化的问卷调查,记录患者症状的变化及口颌系统的不适感和副作用.结果与戴用矫治器前比较,26 例的呼吸暂停低通气指数下降了 50 % 以上,客观有效率为 89.7 %;呼吸暂停指数和低通气指数分别降低 74.39 % 和 47.94 %(P<0.01),夜间最低血氧饱和度明显升高(P<0.01).戴用矫治器初期不适症状主要为唾液增多及晨起后短暂的颞下颌关节和牙齿的酸胀感,一周内不适感基本消失.结论双(牙合)板矫治器是治疗轻、中度OSAS 的有效方法,其长期疗效和副作用尚待进一步观察.

Treatment of OSAS with modified twin-block advancement appliances

Objective To introduce a new modified twin block advancement appliance and investigate the effects on respiratory variables in patients with OSAS.Methods 29 patients with OSAS participated in the study and were fitted with modified twin block appliances to hold the mandible in an anterior and inferior position. Polysomnography was performed with and without appliance insertion. And questionnaires were used for registration of patients subjective symptoms. Pair t analysis was used to evaluate the effects of appliances in patients with OSAS.Results 26 patients responded to the appliance therapy. Apnea hypopnea index, apnea index and hypopnea index were reduced significantly ( P <0 01). Lowest arterial oxygen saturation improved significantly ( P <0 01). Discomfort with mandibular advancement disappeared within one week.Conclusions Modified twin block advancement appliance is a conservative, successful treatment alternative that could benefit patients suffered from OSAS.