本文選題：阻塞性睡眠呼吸暫停低通氣綜合征 + 顳下頜關(guān)節(jié)　； 參考：《中國人民解放軍醫(yī)學院》2017年碩士論文

【摘要】：第一部分阻塞性睡眠呼吸暫停低通氣綜合征患者顳下頜關(guān)節(jié)間隙測量目的通過對阻塞性睡眠呼吸暫停低通氣綜合征患者的顳下頜關(guān)節(jié)行磁共振掃描分析,探討OSAHS患者與正常人群的顳下頜關(guān)節(jié)形態(tài)學差異。方法選取2014年1月至2016年5月收治的18例OSAHS患者和18例健康成人,分別記為研究組(n=18 )和對照組(n=18 ),再按照呼吸暫停及低通氣指數(shù)(apnea andhypopneaindex,AHI)將OSAHS患者分為輕、中、重3個亞組(n=6)。對所有納入人群行TMJ的磁共振(Magnetic Resonance Imaging, MRI)掃描并測量關(guān)節(jié)間隙,并采用spss17.0軟件包對測量數(shù)據(jù)行統(tǒng)計學處理,組間計量資料行獨立樣本t檢驗,計數(shù)資料行χ2檢驗,多組間比較采用單因素方差分析。結(jié)果①2組患者在年齡、性別構(gòu)成比例、關(guān)節(jié)上間隙及髁突有無移位方面差異均無統(tǒng)計學意義(P 0. 05 )。②OSAHS患者TMJ左側(cè)前間隙[(2.61 ± 0.19)mm :(2.47 ± 0. 18)mm,P0.05]、右側(cè)前間隙[(2.63 ± 0.18)mm : ( 2.48 ± 0. 17)mm,P0.05]大于正常人群。OSAHS患者TMJ左側(cè)后間隙[(2.43 ± 0.20)mm : ( 2.51 ±0.19)mm,P0.05]、右側(cè)后間隙[(2.44±0.20)mm : ( 2.60 ± 0.13)mm,P0.05]小于正常人群。③輕度OSAHS組TMJ左側(cè)前間隙[(2.53 ± 0.26)mm : ( 2.73 ±0.07)mm,P0.05]、右側(cè)前間隙[(2.54 ± 0.11)mm : ( 2.74 ± 0.14)mm,P0.05]均小于重度組;輕度OSAHS組TMJ左側(cè)后間隙[(2.56 ± 0.29)mm : ( 2.29 ±0.09)mm,P0.05]、右側(cè)后間隙[(2.55±0.23)mm : ( 2.31 ± 0.09)mm,P0.05]均大于重度組。結(jié)論OSAHS患者的髁突相較于正常人群位于關(guān)節(jié)窩偏后位置。髁突位于關(guān)節(jié)窩偏后位置的趨勢與OSAHS嚴重程度相關(guān)。第二部分OSAHS患者與正常人群RDC/TMD軸Ⅰ診斷對比目的分析我國阻塞性睡眠呼吸暫停低通氣綜合征患者與正常人群顳下頜關(guān)節(jié)紊亂病的流行病學差異。方法將2015年11月至2016年11月至我院就診OSAHS患者及正常人群按1:1行個體配對,分別記為OSAHS組(n=64)和對照組(n=64)。應(yīng)用陳偉生等建立的顳下頜關(guān)節(jié)紊亂病研究診斷標準(RDC/TMD)軸Ⅰ中文版,對2組人群進行臨床檢查以及調(diào)查問卷填寫,根據(jù)結(jié)果進行診斷分類,包括第一組診斷:肌病類;第二組診斷:關(guān)節(jié)盤移位類:第三組診斷:關(guān)節(jié)痛、關(guān)節(jié)炎、關(guān)節(jié)病類。采用spss17.0軟件包對測量數(shù)據(jù)行統(tǒng)計學處理,計數(shù)資料行χ2檢驗。結(jié)果①共有138例受試者完成調(diào)查,有效量表128例,其中男98例,女30例,男女比例3.3:1,年齡、性別構(gòu)成比例差異無統(tǒng)計學意義(P0. 05)。②2組人群TMD患病率及各亞型診斷間差異均無統(tǒng)計學意義(P 0. 05)③.22/64 vs.12/64,(P0.05)方面大于正常人群,差異有統(tǒng)計學意義。結(jié)論OSAHS患者的TMD亞型診斷較正常人群復雜。OSAHS患者一旦合并TMD,將面臨較正常人群更為嚴重的TMD發(fā)展趨勢。
[Abstract]:The first part: temporomandibular joint space measurement in patients with obstructive sleep apnea hypopnea syndrome objective to analyze the temporomandibular joint in patients with obstructive sleep apnea hypopnea syndrome by magnetic resonance imaging. Objective: to investigate the morphological differences of temporomandibular joint between OSAHS patients and normal subjects. Methods from January 2014 to May 2016, 18 OSAHS patients and 18 healthy adults were selected as study group (n = 18) and control group (n = 18). According to apnea and hypopnea index (AHII), OSAHS patients were divided into three subgroups: mild, moderate and heavy. All subjects were scanned and measured by magnetic resonance imaging (MRI) of TMJ. The measured data were statistically processed by spss17.0 software package, independent sample t-test was performed among groups, and 蠂 2 test was performed for counting data. Single factor analysis of variance (ANOVA) was used for multi-group comparison. Results there were no significant differences in age, sex ratio, supraarticular space and condylar process displacement in 12 groups. Left anterior space of TMJ [2.61 鹵0.19)mm: 2.47 鹵0. The right anterior space [2.63 鹵0.18)mm: (2.48 鹵0)]. The left posterior space of OSAHS patients was significantly higher than that of normal subjects [2.43 鹵0.20)mm: (2.51 鹵0.19mm) P0.05], and the right posterior space [2.44 鹵0.20)mm: (2.60 鹵0.13mm) P0.05] was lower than that of normal subjects [2.53 鹵0.26)mm: 2.73 鹵0.07mm], and the right anterior space was 2.54 鹵0.11)mm. 鹵0.14 鹵0.14 mm (P0.05) was lower than that in severe group. In the mild OSAHS group, the left posterior space of TMJ [2.56 鹵0.29)mm: (2.29 鹵0.09) 0.29)mm], and the right posterior space [2.55 鹵0.23)mm: (2.31 鹵0.09) 0.29)mm] were higher than those in the severe group. Conclusion the condyle of OSAHS patients is located in posterior position of articular fossa. The tendency of condylar process in the posterior position of articular fossa is related to the severity of OSAHS. Part two: comparative diagnosis of RDC / TMD axis 鈪，

本文編號：2016024