發(fā)布時間：2018-05-05 12:59

  本文選題：阻塞性睡眠呼吸暫停低通氣綜合征 + 下頜前伸止鼾器�。� 參考：《昆明醫(yī)科大學(xué)》2017年碩士論文

【摘要】：[目的]使用下頜前伸止鼾器(MASSD)治療輕、中度OSAHS患者,對其術(shù)前、術(shù)后多導(dǎo)睡眠監(jiān)測(PSG)、柏林問卷(BQ)、嗜睡量表(ESS)、舒適度問卷表進行對比研究,評價MASSD治療OSAHS臨床療效;對傳統(tǒng)下頜前伸定位在臨床應(yīng)用中的不足,研制便攜式下頜前伸定位器。[方法]1.研究納入30例輕、中度OSAHS患者。使用MASSD治療OSAHS,并進行術(shù)前、術(shù)后6個月臨床對比研究。客觀療效觀察指標為PSG監(jiān)測指標:呼吸暫停指數(shù)(AHI)、鼾聲次數(shù)、最低血氧飽和度(LSa02);主觀療效觀察指標:柏林問卷(BQ)、嗜睡量表(ESS)、舒適度問卷調(diào)查表。對各項觀察指標數(shù)據(jù)采用SPSS21.0軟件包進行自身配對t檢驗。2.探討目前常見的幾種下頜前伸定位方法的不足,聯(lián)合昆明理工大學(xué)和上海IIBM公司,對步進電機、步進電機驅(qū)動器、電源、藍牙模塊、安卓系統(tǒng)智能手機、血氧飽和儀等裝置進行改裝和編寫程序,完成便攜式下頜前伸定位器制作,根據(jù)患者主觀感受和監(jiān)測數(shù)據(jù),計算機輔助確定下頜前伸距離,實現(xiàn)“個性化”下頜前伸距離的調(diào)節(jié),提高治療效果及舒適度。[結(jié)果]1.30例輕、中度OSAHS患者戴用下頜前伸止鼾器,經(jīng)6個月隨訪觀察,客觀結(jié)果顯示:治療后平均AHI指數(shù)降為(10.24±4.25)次/h;最低血氧飽和度(Lsao2)顯著提高,均≥91 %。經(jīng)統(tǒng)計學(xué)分析,療效肯定(P0.05)。因鼾聲次數(shù)不服從正態(tài)分布,結(jié)果以P50 (P25,P75)表示,治療前后差異用秩和檢驗0.001。主觀問卷調(diào)查結(jié)果顯示:本實驗30例患者戴用止鼾器后其中27例脫離呼吸暫停風險,3例患者雖然沒有脫離呼吸暫停風險,但有所緩解;30例患者中較舒適12例,占40%、舒適13例,占43.33%、不適患者3例,占10%、明顯不適患者2例,占6.67%,患者術(shù)后主要會有牙齒酸痛、口干、早晨起床后咬合不適、唾液增多、臉頰、關(guān)節(jié)區(qū)酸脹等不適癥狀,5例不適患者經(jīng)下頜前伸距離調(diào)改后,舒適度提高,全都愿意佩戴止鼾器。2.完成自制便攜式下頜前伸定位器。[結(jié)論]1. MASSD是治療輕、中度阻塞性呼吸暫停低通氣綜合征(OSAHS)的有效方法。2.下頜前伸量大小與下頜前伸止鼾器的療效密切相關(guān),前伸量過小達不到治效果,過大會導(dǎo)致患者不適甚至產(chǎn)生副作用,說明MASSD行下頜前伸精確定位需要進一步研究。3.自制便攜式下頜前伸定位器實現(xiàn)“個性化”.下頜前伸距離的調(diào)節(jié),提高療效及舒適度。有望在臨床上得到推廣應(yīng)用。
[Abstract]:[objective] to evaluate the clinical efficacy of MASSD in the treatment of mild and moderate OSAHS patients with mild and moderate OSAHS by using mandibular protruding and snoring arrester (MASSD). The results were compared with those of polysomnography, Berlin questionnaire, somnolence scale and comfort scale before and after operation. A portable mandibular protruding locator was developed for the deficiency of traditional mandibular protruding localization in clinical application. [methods] 1. The study included 30 mild and moderate OSAHS patients. MASSD was used in the treatment of OSAHS, and a comparative clinical study was carried out 6 months before and 6 months after operation. The objective curative effect indexes were as follows: apnea index: apnea index, snoring frequency, lowest blood oxygen saturation, LSa02a, subjective efficacy observation index: Berlin questionnaire, somnolence scale, and comfort questionnaire. SPSS21.0 software package was used to carry out self-paired t test. 2. 2. This paper discusses the shortcomings of several common methods of mandibular protruding positioning, combines Kunming University of Technology and Shanghai IIBM Company, compares stepping motor, stepper motor driver, power supply, Bluetooth module, Android smart phone, etc. The device such as blood oxygen saturation instrument was modified and programmed to make the portable mandibular protruding positioner. According to the patient's subjective feeling and monitoring data, the distance of mandibular protruding was determined by computer. The adjustment of mandibular protruding distance can be realized, and the therapeutic effect and comfort can be improved. [results] 1.Thirty patients with mild and moderate OSAHS wore mandibular protruding snoring apparatus. After 6 months follow-up observation, the objective results showed that the average AHI index decreased to 10.24 鹵4.25 times / h after treatment, and the lowest oxygen saturation (Lsao2) increased significantly (all 鈮，

本文編號：1847776