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目的:通过评估骨性Ⅲ错合畸形患者正颌手术后睡眠时期的呼吸功能情况,研究该类患者正颌手术后存在呼吸道梗阻的可能性。为临床治疗提供依据。方法:分析56例接受正颌手术的骨性Ⅲ类错合畸形患者的术前及术后1周、1月、3月和术后6月的多导睡眠图报告。设计问卷调查表评估手术影响日间嗜睡度的变化。从PSG报告上获得的术前术后有代表性的2项参数睡眠呼吸暂停低通气指数与最低氧饱和度分别进行比较。结果:数据显示术前和术后AHI指数及SpO2无显著性差异(统计学上无差异)。54例病人术后均未出现睡眠呼吸障碍症状。2例病人术后出现睡眠时期打鼾,但术后随访6月后打鼾逐渐消失。结论:骨性Ⅲ类错合畸形患者正颌术后无明显呼吸道梗阻症状。但若患者同时具有超重、短颈、舌体大等其他危险因素及仅行下颌骨后退手术可能导致睡眠呼吸暂停低通气综合症的发生。
Objective: To evaluate the respiratory function of patients with skeletal Ⅲ malformations after orthognathic surgery during sleep stage and to study the possibility of respiratory obstruction after orthognathic surgery. Provide the basis for clinical treatment. Methods: The polysomnography reports of 56 patients with skeletal class Ⅲ malocclusion under orthognathic surgery were analyzed preoperatively and 1 week, 1 month, 3 months and 6 months after operation. Design Questionnaire to assess the effect of surgery on daytime sleepiness changes. Preoperative and postoperative results obtained from the PSG report, two parameters of sleep apnea hypopnea index and the lowest oxygen saturation were compared. RESULTS: The data showed no significant difference in preoperative and postoperative AHI indices and SpO2 (statistically no difference). None of the 54 patients presented with symptoms of sleep-disordered breathing. Two patients experienced postoperative snore during sleep, but snoring gradually disappeared after 6 months of follow-up. Conclusion: Orthognathic surgery has no obvious respiratory obstruction in patients with skeletal Class Ⅲ malocclusion. However, if the patient also has other risk factors such as overweight, short neck and large tongue, and only the mandibular recuperation may lead to sleep apnea-hypopnea syndrome.