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目的:探讨双合垫矫治器治疗儿童下颌后缩合并阻塞性睡眠呼吸暂停低通气综合征的临床效果。方法:21例下颌后缩合并阻塞性睡眠呼吸暂停低通气综合征患儿均采用双合垫矫治器治疗,分别于治疗前、后进行多导睡眠监测,并拍摄X线头颅侧位片,比较治疗前、后夜间睡眠呼吸暂停低通气指数、夜间最低血氧饱和度和X线头颅侧位片头影测量结果。结果:佩戴双合垫矫治器后,21例患儿睡眠时鼾声减少6例、鼾声消失15例,日间困倦缓解7例、消失14例,均未见睡眠中憋气,睡眠呼吸暂停低通气指数较治疗前降低(P<0.01),夜间最低血氧饱和度较治疗前提高(P<0.05)。治疗前、后颅底平面-上齿槽座点角比较差异无统计学意义(P>0.05),前颅底平面-下齿槽座点角较治疗前增大(P<0.05)。结论:双合垫矫治器可增加患儿气道宽度,防止睡眠时气道闭合引起的呼吸暂停,促进下颌骨的生长,患儿面型得到明显改善。
Objective: To investigate the clinical effect of double-padded appliance in the treatment of children mandibular retrusion and obstructive sleep apnea-hypopnea syndrome. Methods: Twenty-one children with mandibular retrusion and obstructive sleep apnea-hypopnea syndrome were treated with double-padded appliance. Polysomnography was performed before and after treatment, and X-ray cephalograms were compared. Pre-and post-nocturnal sleep apnea-hypopnea index, nighttime minimum oxygen saturation and X-ray cephalometric cephalometric measurements. Results: After wearing double-padded appliance, the incidence of snoring decreased in 6 cases, snoring disappeared in 15 cases, daytime sleepiness relieved in 7 cases and disappeared in 14 cases. No sleep apnea, sleep apnea-hypopnea index Lower than before treatment (P <0.01), night minimum oxygen saturation than before treatment increased (P <0.05). There was no significant difference in the posterior skull base-upper alveolar anterior angle before and after treatment (P> 0.05). The point angle of the anterior skull base plane-inferior alveolar anterior horn increased before treatment (P <0.05). Conclusion: Shuanghe pad appliance can increase airway width, prevent apnea caused by airway closure during sleep, promote the growth of mandible and improve the facial shape of children.