不同正颌术式治疗重度OSAHS患者的疗效观察

doi:10.3969/j.issn.1005-4979.2018.03.006

摘要/Abstract

摘要： 目的：对比分析两种手术方式治疗重度阻塞性睡眠呼吸暂停低通气综合征（OSAHS）的临床效果。方法：选取2012-01—2016-01在本院行正颌手术治疗重度OSAHS的患者30例，并结合临床资料进行回顾性分析。其中，13例患者采取双颌水平前徙术联合颏成形术（A组），17例患者采用双颌逆时针旋转联合颏成形术（B组）。结果：术前A、B两组患者的SAN角、SNB角、SNP角、PAS距离差异无统计学意义（P>0.05），术后两组患者的SAN角、SNB角、SNP角、PAS距离较本组术前有差异，差异有统计学意义（P<0.05）。同时，术后B组患者的SAN角、SNB角、SNP角显著的低于A组（P<0.05），B组的PAS距离显著的大于A组（P<0.05）。术后，两组患者的AHI、AI较手术前明显降低（P<0.05），MinSpO2较手术前明显升高（P<0.05）。术后6个月进行手术效果评价，A组达到手术成功标准的病例为12例，B组为17例，两组手术成功率差异无统计学意义（P>0.05）。结论：两种手术方式治疗重度OSAHS的效果均较好，但是双颌逆时针旋转联合颏成形术对患者颌面部外形影响更小。

关键词: 正颌手术, 阻塞性, 睡眠呼吸暂停, 低通气综合征

Abstract: Objective: To observe the clinical effects of two surgical methods in treatment of severe obstructive sleep apnea hypopnea syndrome (OSAHS). Methods: Thirty patients with severe OSAHS who underwent orthognathic surgery in our hospital from January 2012 to January 2016 were retrospectively analyzed.13 patients were treated with double maxillary horizontal migration and genitoplasty (group A), and the other 17 patients were treated with double maxillary clockwise rotation combined genitoplasty (group B). Results: Before operation, the differences of SAN angle, SNB angle, SNP angle and PAS distance in the two groups were not statistically significant (P>0.05). After operation, the SAN angle, SNB angle, SNP angle and PAS distance in the two groups were significantly higher than those before the operation (P<0.05). After operation, the SAN angle, SNB angle and SNP angle in group B were significantly lower than those in group A (P<0.05). The PAS distance in group B was significantly greater than that in group A (P<0.05). After the operation, the AHI and AI of the two groups were significantly lower than those before the operation (P<0.05), and the MinSpO2 was significantly higher than that before the operation (P<0.05). The operative effect was evaluated at 6- month after operation. In group A, 12 cases were successful in operation, while 17 cases achieved success in group B. No significant difference were observed in the operative success rate between two groups (P>0.05). Conclusion: The two kinds of surgical treatment for severe OSAHS were both effective. but the double maxillary clockwise rotation combined genioplasty operation showed less change on the facial contour of the patients.

Key words: positive jaw surgery, obstructive, obstructive sleep apnea syndrome

中图分类号:

R856.78

刘志勇，张楠. 不同正颌术式治疗重度OSAHS患者的疗效观察[J]. 《口腔颌面外科杂志》, doi: 10.3969/j.issn.1005-4979.2018.03.006.

LIU Zhi-yong, ZHANG Nan. Observation of the Curative Effect of Different Operative Methods in the Treatment of Patients with Severe OSAHS[J]. 《Journal of Oral and Maxillofacial Surgery》, doi: 10.3969/j.issn.1005-4979.2018.03.006.

https://journal06.magtech.org.cn/Jweb_joms/CN/Y2018/V28/I3/152

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