可调式阻鼾器治疗阻塞性睡眠呼吸暂停低通气综合征

目的　探讨可调式阻鼾器在阻塞性睡眠呼吸暂停低通气综合征 (OSAHS)治疗中的应用。方法　可调式阻鼾器组 30例OSAHS患者(男 24例,女 6例),平均年龄(49 9±9 9)岁,呼吸暂停及低通气指数 (AHI) ( 33 1±22 7 )次 /h。对照组为同期治疗的 30例年龄、体重、病情相当的OSAHS患者(男 23例,女 7例),戴用普通下颌前移类矫治器。单盲法取证并比较两组疗效的差异;分析可调式阻鼾器组患者于治疗前、医师经验位和最终调整位的上气道、舌骨位置和下颌定位的差异。结果　可调式阻鼾器组的AHI值相对降低 85 8 %,高于对照组 (P<0 05);其最终调整位为下颌前伸(5 8±1 4)mm,上下切缘距(4 6±1 1)mm,占最大前伸量的(71±26)%。结论　可调式阻鼾器的疗效改善明显,其最终调整位可为下颌定位的研究提供参考。

An adjustable appliance in treatment of obstructive sleep apnea-hypopnea syndrome

OBJECTIVE: The research tended to approach applying of adjustable appliance in the treatment of obstructive sleep apnea-hypopnea syndrome (OSAHS). METHODS: 30 OSAHS patients (24 males and 6 females) participated in the adjustable group, with a mean age of (49.9 +/- 9.9) years old. AHI was (33.1 +/- 22.7) per hour. The control group consisted of 30 OSAHS patients wearing ordinary mandibular advancing appliance in the corresponding period, with age, weight and AHI at the same level. Monoblind way was designed to obtain and analyze the therapy differences. Differences in changes of upper airway, mandible and hyoid bone were also analyzed among the doctor-experience position, final adjusted position and original position. RESULTS: AHI decreased by 85.5% in the adjustable appliance group. The change in AHI was greater significantly (P = 0.025) in the adjustable group than in the control group. In the final adjusted position, the amount of mandibular advancement was (5.8 +/- 1.4) mm (71 +/- 26)% of the maximum range of protrusion] and that of bite opening (the distance between upper and lower incisor edges) was (4.6 +/- 1.1) mm. CONCLUSIONS: The adjustable appliance had shown better therapy effect in OSAHS patients. The final adjusted position provided usful information on determining mandibular position using other appliances.