口腔矫治器和持续气道正压通气治疗中度OSAHS伴下颌后缩患者的疗效对比

目的 对比分析口腔矫治器(OA)、持续性气道正压通气(CPAP)治疗中度阻塞性睡眠呼吸暂停低通气综合征(OSAHS)伴下颌后缩患者的疗效差别。 方法 选取中度OSAHS伴下颌后缩的患者42例,根据治疗方式的不同分为CPAP治疗组(n=21)和OA治疗组(n=21); 另选取不伴下颌后缩的OSAHS患者50例,根据治疗方式的不同分为CPAP治疗组(n=25)和OA治疗组(n=25)。对比分析4组患者治疗前后嗜睡量表(ESS)评分、鼾声(SS)评分、呼吸暂停低通气指数(AHI)、氧减指数(ODI)和最低血氧饱和度(LSaO₂)等。 结果 治疗6月后,4组患者的ESS评分,SS评分,AHI,ODI和LSaO₂均较治疗前显著改善(P<0.05)。治疗后各组间ESS评分差别无统计学意义(P>0.05)。CPAP治疗在改善SS评分,AHI,ODI及LSaO₂方面均优于OA治疗(P<0.05)。OA治疗组中,OSAHS伴下颌后缩的患者在改善AHI及ODI方面优于不伴下颌后缩的患者(P<0.05)。 结论CPAP和OA治疗中度OSAHS伴下颌后缩患者疗效肯定; OA的治疗效果,伴下颌后缩的患者优于不伴下颌后缩的患者。

Comparison of the Effectiveness of Oral Appliance versus Continuous PositiveAirway Pressure in Treating Moderate OSAHS Patients with Mandibular Retrusion

Objective To compare and analyze the effectiveness of oral appliance(OA)versus continuous positive airway pressure(CPAP)in treating moderate OSAHS patients with mandibular retrusion. Methods Ninety-two patients with moderate OSAHS were selected, among them 42 moderate OSAHS patients with mandibular retraction were divided into CPAP treatment group(n=21)and OA treatment group(n=21)according to different treatment methods; and 50 moderate OSAHS patients without mandibular retraction were divided into CPAP treatment group(n=25)and OA treatment group(n=25)according to different treatment methods. ESS score, SS score, AHI, ODI, and LSaO₂ were obtained and compared before and after 6 months of treatment in 4 groups. Results After 6 months, ESS score, SS score, AHI, ODI, and LSaO₂ of the 4 groups were significantly improved compared with those before treatment(P<0.05). There was no significant difference in ESS scores between the 4 groups after treatment(P>0.05). SS score, AHI, ODI, and LSaO₂ were significantly improved in CPAP groups compared with OA groups(P<0.05). The OA treatment group of OSAHS patients with mandibular retraction was superior to the OA treatment group of OSAHS patients without mandibular retraction in terms of improving AHI and ODI(P<0.05). Conclusion Both CPAP and OA have a positive effect in treating moderate OSAHS patients with mandibular retraction, and treatment effect of OA on OSAHS patients with mandibular retraction is better than they on patients without mandibular retraction.