中华整形外科杂志
中華整形外科雜誌
중화정형외과잡지
CHINESE JOURNAL OF PLASTIC SURGERY
2011年
5期
332-336
,共5页
傅潇慧%陈军%徐旭辉
傅瀟慧%陳軍%徐旭輝
부소혜%진군%서욱휘
骨生成,牵张%小颌畸形%睡眠呼吸暂停综合征%体层摄影术,螺旋计算机
骨生成,牽張%小頜畸形%睡眠呼吸暫停綜閤徵%體層攝影術,螺鏇計算機
골생성,견장%소합기형%수면호흡잠정종합정%체층섭영술,라선계산궤
Osteogenesis,distraction%Micrognathism%Sleep apnea syndromes%Tomography,spiral computed
目的 探讨应用牵引成骨技术治疗严重小颌畸形伴中、重度阻塞性睡眠呼吸暂停低通气综合征(obstructive sleep apnea and hypopnea syndrome，OSAHS)的疗效。方法 采用下颌骨牵引成骨技术治疗严重小颌畸形伴中、重度OSAHS患者19例，分别于术前、后行多导睡眠监测仪监测及螺旋CT扫描，评价疗效并比较患者上气道三维结构的改变。结果 根据OSAHS疗效判定标准，19例中17例治愈，2例显效；手术后上气道各段的矢状径、矢状面积、横径和横截面积均较术前明显增加，气道容积从治疗前的(15 572.03±3 370.11) mm3变为治疗后的(21 182.69±4 533.15) mm3，变化主要发生在腭咽及舌咽，喉咽变化不明显。腭咽及舌咽区段气道各项检测指标与术前相比，差异均有统计学意义（P＜0.01或P＜0.05））。结论 下颌骨牵引成骨技术可明显扩张上气道腭咽段和舌咽段气道容积，从而有效治疗严重小颌畸形伴中、重度OSAHS。CT作为一种影像学手段，在该研究中有独到和重要的作用。
目的 探討應用牽引成骨技術治療嚴重小頜畸形伴中、重度阻塞性睡眠呼吸暫停低通氣綜閤徵(obstructive sleep apnea and hypopnea syndrome，OSAHS)的療效。方法 採用下頜骨牽引成骨技術治療嚴重小頜畸形伴中、重度OSAHS患者19例，分彆于術前、後行多導睡眠鑑測儀鑑測及螺鏇CT掃描，評價療效併比較患者上氣道三維結構的改變。結果 根據OSAHS療效判定標準，19例中17例治愈，2例顯效；手術後上氣道各段的矢狀徑、矢狀麵積、橫徑和橫截麵積均較術前明顯增加，氣道容積從治療前的(15 572.03±3 370.11) mm3變為治療後的(21 182.69±4 533.15) mm3，變化主要髮生在腭嚥及舌嚥，喉嚥變化不明顯。腭嚥及舌嚥區段氣道各項檢測指標與術前相比，差異均有統計學意義（P＜0.01或P＜0.05））。結論 下頜骨牽引成骨技術可明顯擴張上氣道腭嚥段和舌嚥段氣道容積，從而有效治療嚴重小頜畸形伴中、重度OSAHS。CT作為一種影像學手段，在該研究中有獨到和重要的作用。
목적 탐토응용견인성골기술치료엄중소합기형반중、중도조새성수면호흡잠정저통기종합정(obstructive sleep apnea and hypopnea syndrome，OSAHS)적료효。방법 채용하합골견인성골기술치료엄중소합기형반중、중도OSAHS환자19례，분별우술전、후행다도수면감측의감측급라선CT소묘，평개료효병비교환자상기도삼유결구적개변。결과 근거OSAHS료효판정표준，19례중17례치유，2례현효；수술후상기도각단적시상경、시상면적、횡경화횡절면적균교술전명현증가，기도용적종치료전적(15 572.03±3 370.11) mm3변위치료후적(21 182.69±4 533.15) mm3，변화주요발생재악인급설인，후인변화불명현。악인급설인구단기도각항검측지표여술전상비，차이균유통계학의의（P＜0.01혹P＜0.05））。결론 하합골견인성골기술가명현확장상기도악인단화설인단기도용적，종이유효치료엄중소합기형반중、중도OSAHS。CT작위일충영상학수단，재해연구중유독도화중요적작용。
Objective To investigate the effect of distraction osteogenesis(DO) in the treatment of severe mandibular micrognathia with severe obstructive sleep apnea and hypopnea syndrome (OSAHS).Methods 19 cases of severe mandibular micrognathia with OSAHS were treated by DO. All the patients received PSG and MSCT examination before and after DO to evaluate the therapeutic effect and changes in the upper airway. Results According to the evaluation standard, 17 cases were cured and 2 cases improved markedly. The saggital distance and area, transverse distance and area of the upper airway increased markedly after DO. The volume of upper airway increased from( 15 572.03 ± 3 370. 11 ) mm3 to (21 182.69 +4 533.15) mm3. The airway change happened mainly in velopharyngeral region and the lingopharyngeal region, but not in the laryngoppharyngeal region. Conclusions DO can treat severe mandibular micognathia patients with OSAHS effectively by enlarging the volume of upper airway, especially in the velopharynx and glossopharyngeum region. The MSCT plays an effective and important role.
