CAJ | 학술논문

目的:观察一种下颌前移性口矫器治疗阻塞性睡眠呼吸暂停(OSA)的疗效并探讨其治疗原理,探讨应用颌面结构分析法来预测口矫器的疗效. 方法:70例经多导睡眠仪(PSG)检查确诊的OSA患者,男性63例,女性7例,平均年龄:(50.5±11.6)岁,呼吸暂停指数(AI)(34.9±21.3)次/h,夜间最低血氧饱和度(66.3±16.5)%.经口腔科会诊后制作口矫器,治疗3个月后复查PSG检查.每例患者治疗前均在带及不带口矫器两种状态下摄头颅侧位片作颌面结构分析. 结果:治疗后AI由(34.9±21.3)次/h减至(15.6±19.2)次/h(P<0.000 1),夜间最低血氧饱和度由(66.3±16.6)%升至(74.1±15.5)%(P<0.001).共有45例患者AI减少≥50%.反应良好组患者缩颌较明显,前上面部长度较长,置入口矫器后下颌显著前突、上气道径增宽、长度缩短、上气道面积增大. 结论:口矫器对部分OSA患者具有确切疗效,其治疗作用可能主要与改善睡眠期上气道周围结构关系,保持气道通畅有关.
목적:관찰일충하합전이성구교기치료조새성수면호흡잠정(OSA)적료효병탐토기치료원리,탐토응용합면결구분석법래예측구교기적료효. 방법:70례경다도수면의(PSG)검사학진적OSA환자,남성63례,녀성7례,평균년령:(50.5±11.6)세,호흡잠정지수(AI)(34.9±21.3)차/h,야간최저혈양포화도(66.3±16.5)%.경구강과회진후제작구교기,치료3개월후복사PSG검사.매례환자치료전균재대급불대구교기량충상태하섭두로측위편작합면결구분석. 결과:치료후AI유(34.9±21.3)차/h감지(15.6±19.2)차/h(P<0.000 1),야간최저혈양포화도유(66.3±16.6)%승지(74.1±15.5)%(P<0.001).공유45례환자AI감소≥50%.반응량호조환자축합교명현,전상면부장도교장,치입구교기후하합현저전돌、상기도경증관、장도축단、상기도면적증대. 결론:구교기대부분OSA환자구유학절료효,기치료작용가능주요여개선수면기상기도주위결구관계,보지기도통창유관.
Objectives: To identify any craniofacial morphological changes induced by a mandibular-repositioning oral appliance (MRA) and to explore the possibility of predicting the treatment response to MRA by cephalometric analysis in patients with obstructive sleep apnea (OSA). Methods: Seventy OSA patients [male/female: 63/7; age: (50.5±11.6) years; BMI: (27.6±4.6) kg/m2; AI: (34.9±21.3) episodes/hour; and oxygen saturation nadir: (66.3±16.5) %] were enrolled. MRA was fabricated individually for each patient after the consultation by a dentist. Polysomnographic (PSG) examination was repeated with MRA in place 3 months after the initiation of the MRA therapy. For cephalometric analysis, a pair of cephalograms of each patient was obtained, one with and another without MRA. Results and Conclusions: After 3 months' treatment, AI was (156±19.2) episodes/hour, significantly reduced compared with the pre-treatment average AI (34.9±21.3 episodes/hour,P<0.000 1). Oxygen saturation nadir improved from (66.3±16.5)% (pre-treatment) to (74.1±15.5)% (with MRA) (P<0.001). A reduction of AI≥50% was achieved in 42 patients. Insertion of MRA led to anterior shift of the mandible, increase in upper airway width and area and decrease in upper airway length. Those with evident retrognathia and longer anterior upper facial height were more likely to benefit from the MRA management.