CAJ | 학술논문

目的通过对OSAHS的口腔矫治器治疗前后的PSG数据分析,探讨血氧饱和度对于口腔矫治器治疗效果评价的重要性,并重新思考OSAHS口腔矫治器的适应证及疗效评价指标.方法纳入12例口腔矫治器治疗OSAHS“疗效不佳”,即佩戴矫治器时AHI＞10的病例,对其佩戴矫治器前和佩戴矫治器时的AHI、平均血氧饱和度、最低血氧饱和度、ST90等进行逐一对比分析.结果结合患者主观感受及PSG数据综合考量:12例病例中,7例佩戴矫治器时虽AHI＞ 10,但AHI改善幅度及血氧饱和度改善程度较为理想,可继续口腔矫治器治疗并保持现有疗效;2例佩戴矫治器时AHI或血氧饱和度改善不理想,需对口腔矫治器再次调节以加强疗效;3例佩戴矫治器时AHI及血氧饱和度不仅无改善且反而变严重,需更改治疗方法.结论对于OSAHS口腔矫治器治疗,除了观察AHI变化,更应着眼于缺氧的程度和时长是否有所改善.因此,其适应证可不限于轻中度OSAHS,对于AHI＞30但仅伴有轻度低氧血症的患者,同样可以尝试口腔矫治器治疗改善鼾声及缺氧;对于其客观疗效评价除AHI的数值或变化幅度外,也需要关注平均血氧饱和度、最低血氧饱和度、ST90等的改善.
목적 통과대OSAHS적구강교치기치료전후적PSG수거분석,탐토혈양포화도대우구강교치기치료효과평개적중요성,병중신사고OSAHS구강교치기적괄응증급료효평개지표.방법 납입12례구강교치기치료OSAHS“료효불가”,즉패대교치기시AHI＞10적병례,대기패대교치기전화패대교치기시적AHI、평균혈양포화도、최저혈양포화도、ST90등진행축일대비분석.결과 결합환자주관감수급PSG수거종합고량:12례병례중,7례패대교치기시수AHI＞ 10,단AHI개선폭도급혈양포화도개선정도교위이상,가계속구강교치기치료병보지현유료효;2례패대교치기시AHI혹혈양포화도개선불이상,수대구강교치기재차조절이가강료효;3례패대교치기시AHI급혈양포화도불부무개선차반이변엄중,수경개치료방법.결론 대우OSAHS구강교치기치료,제료관찰AHI변화,경응착안우결양적정도화시장시부유소개선.인차,기괄응증가불한우경중도OSAHS,대우AHI＞30단부반유경도저양혈증적환자,동양가이상시구강교치기치료개선한성급결양;대우기객관료효평개제AHI적수치혹변화폭도외,야수요관주평균혈양포화도、최저혈양포화도、ST90등적개선.
Objective To reconsider the indications and reevaluate the therapeutic effect of OSAHS oral appliance therapy through analyzing PSG data change.Methods 12 OSAHS cases whose AHI＞10 after using oral appliance were included.Their PSG results (including AHI,mean oxygen saturation,minimum oxygen saturation and ST90) before and after using oral appliance were compared.Results By analyzing both patients' subjective feelings and PSG results,we find that out of the 12 cases,although AHI＞10 after using oral appliance,7 patients get great improvement on oxygen saturation and should continue oral appliance therapy and keep the present effect;2 patients should readjust the oral appliances for lower AHI and higher oxygen saturation;3 patients get worse PSG results after using oral appliance and should turn to other therapies.Conclusions When treating OSAHS and evaluating the effects,more indexes other than AHI should be taken into consideration,especially blood oxygen saturation.Therefore,apart from mild to moderate OSAHS patients,those with AHI＞30 and mild hypoxia should also be indications of oral appliance therapy.The objective evaluation of treatment outcomes should also include AHI,SaO2,minSaO2 and ST90 apart from AHI.