持續性呼吸道正壓通氣合併改良口腔矯正器治療重度OSAHS療效分析

OBJECTIVE: To evaluate the curative effect of continuous positive airway pressure(CPAP) combined with modified oral appliance (MOA) in the treatment of severe OSAHS.

METHOD: The research chose 120 male patients with severe OSAHS. They were treated with CPAP and MOA (30 cases), CPAP (30 cases), and MOA (30 cases) respectively. At the same time, the rest 30 cases without any treatment were in control group (matching factors: age, gender, IBM). After 3 months treatment, the characteristics of PSG and respiratory machine wear condition were observated in four groups.

RESULT: The ESS score in CPAP and MOA group was significantly lower than that in other groups (P < 0.05); After 3 months treatment, the AHI, awake index (AI), and Ni (non-rapid eyemovement sleep1, N1) and N2 (non-rapid eye movement sleep2, N2) period of total sleep time (TST) percentage in CPAP assisted MOA group and CPAP group were significantly lower than that in MOA group and control group (P < 0.05); Sleep efficiency, ESS score, average blood oxygen saturation (MSaO₂), the lowest oxygen saturation (LSaO₂), slow wave sleep phases (SWS) and rapid eyemovement sleep (REM) accounted for the proportion of TST increased significantly (P < 0.05); There was no significant difference between CPAP assisted MOA group and CPAP group in AHI, MSaO₂, AI, sleep efficiency, N1, N2, SWS and REM percentage of TST and ESS score. The LSaO₂ and average machine time in CPAP assisted MOA group were significantly greater than that in CPAP group (P < 0.05), but 90% pressure and average air leakage were significantly lower in the CPAP group (P < 0.05) CONCLUSION: The curative effect of CPCR combined with modified oral appliance was better than CPCR or MOA alone in the treatment of severe OSAHS.