自行调节式口腔矫治器治疗OSAHS的临床疗效评价
【摘要】
目的：采用多导睡眠监测（PSG）、Epworth嗜睡评分量表（ESS）及Berlin睡眠症状调查问卷（BQ），与调节式口腔矫治器相比较，评价自行调节式口腔矫治器治疗轻、中度阻塞性睡眠呼吸暂停低通气综合征（OSAHS）的临床疗效。
方法：经PSG监测及纳入、排除标准筛选出56例轻、中度OSAHS患者，随机分入实验组和对照组，实验组的患者戴用自行调节式口腔矫治器进行治疗，对照组的患者戴用调节式口腔矫治器进行治疗；在戴用矫治器前的1周及戴用后3个月分别对患者进行PSG监测、ESS量表及BQ评分调查，对所获资料进行均数比较、两独立样本t检验及配对t检验，以P<0.05差异有统计学意义。
结果：实验组的OSAHS患者在戴用口腔矫治器前1周及戴用3个月后的PSG监测指标（AI、HI、AHI、LSaO2、最长呼吸暂停时间）、ESS量表和BQ评分变化均有统计学差异。实验组与对照组的OSAHS患者在戴用口腔矫治器前1周及3个月后的PSG监测指标（AI、HI、AHI、LSaO2、最长呼吸暂停时间）变化差值之间无统计学差异，ESS量表和BQ评分变化差值之间有统计学差异；自行调节式口腔矫治器治疗OSAHS的客观有效率为85.7%。
结论：自行调节式口腔矫治器客观上可明显改善OSAHS患者睡眠过程中的呼吸紊乱状况，使患者的睡眠呼吸状况趋向于健康正常人；主观上可有效减轻患者的白天嗜睡、打鼾、起床困倦疲劳等症状，是一种可有效治疗轻、中度OSAHS的口腔矫治器。
【关键词】自行调节式口腔矫治器；阻塞性睡眠呼吸暂停低通气综合征；疗效评价
The clinical evaluation of the self-adjustable oral appliances curing OSAHS(https://www.daowen.com)
Abstract
Objective：Using PSG，ESS and BQ，to evaluate the clinical effects of the self-adjustive oral appliance treated in the mild and moderate obstructive sleep apnea and hypopnea syndrome（OSAHS）patients，compared with adjustive oral appliance.
Methods：56 cases of mild and moderate OSAHS patients selected through PSG examination，inclusion and exclusion criteria were randomly assigned into the experimental group and control group，experimental group patients treated with self-adjustable oral appliance and control group of patients treated with adjustable oral appliance.By treated in the 1 weeks before and after treated 3 months respectively in patients with PSG，ESS and BQ on the survey，the data obtained for mean comparison，two independent samplest testand paired t test，there were statistically significant differences in P<0.05.
Results：The experimental group of OSAHS patients’PSG index（AI，HI，AHI，LSaO2，the longest apnea time），ESS scale and BQ scores in treated 1 week before and after 3 months were significant difference.The experimental group of OSAHS patients’PSG difference（AI，HI，AHI，LSaO2，the longest apnea time）in treated a week before and after 3 months were no significant difference，compared with the control group，there were significant difference between the ESS scale and BQ score difference；The self-ajustable oral appliance’s objective efficiency is 85.7%on OSAHS.
Conclusion：The self-adjustable oral appliance objectively can significantly improve the respiratory disorder during sleep in patients with OSAHS，the sleep breathing condition of patients tend to healthy；and can effectively reduce OSAHS patients’subjective symptoms such as daytime sleepiness，snoring，wake up sleepy fatigue and other symptoms，so it is an effective oral appliance in the treatment of mild to moderate OSAHS.
Key words：self-ajustable oral appliance；OSAHS；evaluation of therapeutic efficiency