本文選題：阻塞性睡眠呼吸暫停低通氣綜合征　切入點(diǎn)：顳下頜關(guān)節(jié)　出處：《昆明醫(yī)科大學(xué)》2017年碩士論文　論文類型：學(xué)位論文

【摘要】：[目的]研究輕、中度OSAHS患者戴用下頜前伸止鼾器治療18個月前后顳下頜關(guān)節(jié)的磁共振影像學(xué)變化,探討其對顳下頜關(guān)節(jié)改建的影響。[方法]選取20例輕、中度OSAHS患者,其中男性17例,女性3例,年齡25-59歲。均采用金屬拉桿式下頜前伸止鼾器治療,分別行治療前和治療18個月后雙側(cè)顳下頜關(guān)節(jié)MRI掃描。選取顳下頜關(guān)節(jié)斜矢狀位圖像采用鐘點(diǎn)法評價(jià)關(guān)節(jié)盤位置,采用kurita分析法研究治療前后髁狀突、關(guān)節(jié)盤及關(guān)節(jié)窩之間位置關(guān)系的改變;斜冠狀位圖像觀察關(guān)節(jié)盤有無內(nèi)外側(cè)移位。對所記錄數(shù)據(jù)采用SPSS21.0軟件進(jìn)行配對t檢驗(yàn)統(tǒng)計(jì)學(xué)分析。[結(jié)果]1. 20例OSAHS患者M(jìn)RI檢查可清晰顯示顳下頜關(guān)節(jié)軟硬組織的解剖結(jié)構(gòu)和相互位置關(guān)系。2.20例OSAHS患者治療前關(guān)節(jié)盤左側(cè)位置為(8.50±2.07°),右側(cè)位置為(8.53±1.15° )。經(jīng)MASSD治療18個月關(guān)節(jié)盤左側(cè)位置為(8.92±1.50° ),右側(cè)位置為(8.95±1.39° ),治療前與治療后對比,關(guān)節(jié)盤位置差異無統(tǒng)計(jì)學(xué)意義(P0.05)。3. MASSD治療前與治療18個月后,關(guān)節(jié)盤與關(guān)節(jié)窩位置關(guān)系(TD/TP)、髁狀突與關(guān)節(jié)窩位置關(guān)系(TC/TP)、關(guān)節(jié)盤與髁狀突的相對位置(TD/TC)治療前后差異無統(tǒng)計(jì)學(xué)意義(P0.05)。4. MASSD治療前與下頜前伸止鼾器治療18個月后,斜冠狀位觀察存在關(guān)節(jié)盤內(nèi)緣超出髁突內(nèi)緣的現(xiàn)象。治療前后盤髁內(nèi)緣間距(ac)和盤髁外緣間距(bd)差異無統(tǒng)計(jì)學(xué)意義(P0.05)。[結(jié)論]1.MRI檢查可清晰顯示顳下全面頜關(guān)節(jié)軟硬組織的解剖結(jié)構(gòu)和相互位置關(guān)系,對診斷顳下頜關(guān)節(jié)病變有臨床指導(dǎo)意義。2.輕、中度OSAHS患者戴用下頜前伸止鼾器治療18個月前后對比顯示顳下頜關(guān)節(jié)影像學(xué)無顯著改變,提示該治療方法對顳下頜關(guān)節(jié)改建無影響。
[Abstract]:[objective] to study the magnetic resonance imaging changes of temporomandibular joint (TMJ) in patients with mild and moderate OSAHS before and after 18 months of treatment with mandibular protruding and snore apparatus. [methods] Twenty patients with mild and moderate OSAHS were selected to study the effect of MRI on temporomandibular joint remodeling. There were 17 males and 3 females aged 25-59 years. Bilateral temporomandibular joint (TMJ) was scanned by MRI before treatment and 18 months after treatment. The position of TMJ was evaluated by hour method on oblique sagittal images of TMJ, and condyle was studied by kurita analysis before and after treatment. The change of the position relationship between the disc and the articular fossa; Oblique coronal images were used to observe the lateral and lateral displacement of the articular disc. The recorded data were analyzed by paired t test with SPSS21.0 software. [results] 1.The MRI examination of 20 patients with OSAHS could clearly show the release of soft and hard tissue of temporomandibular joint. The relationship between the dissection structure and the position of each other was 8.50 鹵2.07 擄on the left side and 8.53 鹵1.15 擄on the right side of the articular disc before and after the treatment of OSAHS. After 18 months of MASSD treatment, the left position of the articular disc was 8.92 鹵1.50 擄, and the right position was 8.95 鹵1.39 擄, which was compared with that before and after the treatment. There was no significant difference in the position of articular disc between the two groups before and after 18 months of treatment with MASSD. The relationship between the position of the disc and the articular fossa, the position of the condyle and the position of the articular fossa, the relative position of the disc and the condyle had no significant difference before and after treatment (P 0.05). 4. Before MASSD treatment and 18 months after the treatment of mandibular protruding and snoring apparatus, there was no significant difference in the relative position between the disc and the condyle. In oblique coronal position, there is a phenomenon that the inner edge of the disc exceeds the inner edge of the condyle. There is no significant difference in the distance between the inner edge of the disc condyle and the outer edge of the disc condyle before and after treatment (P 0.05). [conclusion] 1. MRI can clearly show the subtemporal mandibular joint soft and hard. The anatomical structure of the tissue and its relationship with each other, Clinical guidance for the diagnosis of temporomandibular joint lesions. 2. The contrast between mild and moderate OSAHS patients wearing mandibular protruding snoring apparatus before and after 18 months showed that there was no significant change in temporomandibular joint imaging. The results suggest that this treatment has no effect on temporomandibular joint remodeling.
【學(xué)位授予單位】：昆明醫(yī)科大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2017
【分類號】：R782.6

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