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目的探讨前导下颌型功能矫治器治疗儿童阻塞性睡眠呼吸暂停低通气综合征(OSAHS)的疗效。方法选取我院下颌骨后缩合并OSAHS患儿40例纳入研究,用前导下颌型功能矫治器治疗,观察患者治疗前后上气道结构:口咽气道总体积(V总)、气道最小截面面积(Amin)、最小截面矢状径(V矢)以及最小截面横径(V横),多导睡眠监测(PSG)指标:夜间最低血氧饱和度(SaO2)、最长呼吸暂停时间(MAX)、睡眠呼吸暂停低通气指数(AHI)、呼吸暂停指数(AI),Epworth斯嗜睡(ESS)评分、鼾声(SS)评分、主观症状变化情况。结果与治疗前比较,矫治10个月后患儿上气道V总、Amin、V矢及V横均变大(P<0.05),MAX、AHI、AI明显变小(P<0.05),且夜间SaO2高于治疗前(P<0.05);患儿ESS评分、SS评分相较于治疗前降低(P<0.05);患儿打鼾声音、呼吸暂停、白天犯困等主观症状大部分均消失,没有无变化病例。结论采用前导下颌性功能矫治器治疗下颌后缩合并OSAHS儿童,可有效改善其气道结构、嗜睡情况及各主观症状。
Objective To investigate the curative effect of leading jaw-type functional appliance on obstructive sleep apnea-hypopnea syndrome (OSAHS) in children. Methods Forty children with posterior mandibular reconstruction and OSAHS in our hospital were enrolled in this study. The patients were treated with the mandibular functional appliance, and the upper airway structure was observed before and after treatment: the total volume of the oropharyngeal airway (V total), the minimum airway cross-sectional area (Amin), minimum sagittal (V) and minimum transverse cross-sectional width (V), PSG indicators: nighttime minimum oxygen saturation (SaO2), maximum apnea time (MAX) , Sleep apnea hypopnea index (AHI), apnea index (AI), Epworth sleepiness (ESS) score, snoring (SS) score and subjective symptoms. Results Compared with those before treatment, the total Vmax, Amin, V vector and V transverse dimension of the upper airway became larger (P <0.05), and the values of MAX, AHI and AI were significantly smaller (P <0.05) Nighttime SaO2 was higher than that before treatment (P <0.05); ESS score and SS score in children were lower than those before treatment (P <0.05); Most subjective symptoms such as snoring sound, apnea, No change in cases. Conclusion The treatment of mandibular rectum and OSAHS children with the mandibular functional appliance can effectively improve the airway structure, lethargy and subjective symptoms.