口腔矫正器在阻塞性睡眠呼吸暂停低通气综合征合并咽喉反流中的应用效果(1)
[摘要] 目的 探討口腔矫正器佩戴在阻塞性睡眠呼吸暂停低通气综合征(OSAHS)合并咽喉反流(LPR)患者中的临床应用效果。 方法 选取2016年8月—2018年1月在广州医科大学附属第一医院耳鼻喉头颈外科确诊为OSAHS的46例患者采用6个月口腔矫正器进行干预，分别在干预前、干预6个月后进行多导睡眠监测仪和Dx-pH监测，并完成反流症状指数量表(RSI)和反流体征评分量表(RFS)。比较患者干预前后睡眠打鼾、睡眠呼吸暂停低通气指数(AHI)、24 h pH监测、LPR相关症状、RSI和RFS。 结果 干预前，RSI>13分和/或RFS>7分的患者共17例，干预6个月后仅3例;干预前，立位和/或卧位Ryan指数阳性的患者共11例;干预6个月后仅2例。患者AHI、鼾声指数、RSI、立位Ryan指数、卧位Ryan指数均较干预前显著降低，平均血氧饱和度显著升高，差异有高度统计学意义(P < 0.01)。RSI多个分项(持续清嗓、痰过多或鼻涕倒流、呼吸不畅或反复窒息发作、咽喉异物感)以及RFS分项(喉内黏液附着、弥漫性喉水肿)评分较干预前显著降低，差异有高度统计学意义(P < 0.01)。 结论 口腔矫正器有助于治疗OSAHS合并LPR患者，可明显缓解患者LPR症状。
[关键词] 口腔矫正器;阻塞性睡眠呼吸暂停低通气综合征;咽喉反流;Dx-pH;反流症状指数;反流体征评分
[中图分类号] R766 [文献标识码] A [文章编号] 1673-7210(2020)07(c)-0125-05
Application affect of oral appliance on obstructive sleep apnea-hypopnea syndrom combined with laryngopharyngeal reflux
ZHANG Xiaoping CHEN Gui SONG Lijuan ZHANG Ming
Department of Otolaryngology Head and Neck Surgery， the First Affiliated Hospital of Guangzhou Medical University， Guangdong Province， Guangzhou 510120， China
[Abstract] Objective To investigate the clinical application effect of oral appliance in patients with obstructive sleep apnea-hypopnea syndrom (OSAHS) combined with laryngopharyngeal reflux (LPR). Methods From August 2016 to January 2018， 46 patients diagnosed as OSAHS in the Department of Otolaryngology Head and Neck Surgery， the First Affiliated Hospital of Guangzhou Medical University were selected to receive six-month oral appliance for intervention. Polysomnography monitor and Dx-pH monitoring were performed before and after six months of the intervention respectively， and reflux symptom index (RSI) and reflux fineling score (RFS) were completed. Sleep snoring， sleep apnea hypopnea index (AHI)， 24 h pH monitoring， symptoms related to LPR， RSI and RFS were compared before and after intervention. Results Before intervention， there were seventeen patients with RSI more than thirteen points and/or RFS more than seven points， while only three cases after six months of intervention. Before intervention， there were eleven patients with positive Ryan index in orthostatic and/or decubitus positions， while only two cases after six months of intervention. The AHI， snoring index， RSI， Ryan index in orthostatic position and Ryan index in decubitus position of patients were significantly lower than those before intervention， and mean oxygen saturation was significantly increased， the differences were highly statistically significant (P < 0.01). Scores of multiple RSI items (persistent throat clearing， excessive sputum or nasal reflux， dyspnea or recurrent asphyxia， throat foreign body sensation) and RFS items (laryngeal mucus adhesion， diffuse laryngeal edema) were significantly lower than those before intervention， and the differences were highly statistically significant (P < 0.01). Conclusion Oral appliance is helpful for the treatment of OSAHS patients combined with LPR and can significantly relieve the symptoms of patients with LPR., http://www.100md.com(张小萍 陈桂 宋丽娟 张明)
[关键词] 口腔矫正器;阻塞性睡眠呼吸暂停低通气综合征;咽喉反流;Dx-pH;反流症状指数;反流体征评分
[中图分类号] R766 [文献标识码] A [文章编号] 1673-7210(2020)07(c)-0125-05
Application affect of oral appliance on obstructive sleep apnea-hypopnea syndrom combined with laryngopharyngeal reflux
ZHANG Xiaoping CHEN Gui SONG Lijuan ZHANG Ming
Department of Otolaryngology Head and Neck Surgery， the First Affiliated Hospital of Guangzhou Medical University， Guangdong Province， Guangzhou 510120， China
[Abstract] Objective To investigate the clinical application effect of oral appliance in patients with obstructive sleep apnea-hypopnea syndrom (OSAHS) combined with laryngopharyngeal reflux (LPR). Methods From August 2016 to January 2018， 46 patients diagnosed as OSAHS in the Department of Otolaryngology Head and Neck Surgery， the First Affiliated Hospital of Guangzhou Medical University were selected to receive six-month oral appliance for intervention. Polysomnography monitor and Dx-pH monitoring were performed before and after six months of the intervention respectively， and reflux symptom index (RSI) and reflux fineling score (RFS) were completed. Sleep snoring， sleep apnea hypopnea index (AHI)， 24 h pH monitoring， symptoms related to LPR， RSI and RFS were compared before and after intervention. Results Before intervention， there were seventeen patients with RSI more than thirteen points and/or RFS more than seven points， while only three cases after six months of intervention. Before intervention， there were eleven patients with positive Ryan index in orthostatic and/or decubitus positions， while only two cases after six months of intervention. The AHI， snoring index， RSI， Ryan index in orthostatic position and Ryan index in decubitus position of patients were significantly lower than those before intervention， and mean oxygen saturation was significantly increased， the differences were highly statistically significant (P < 0.01). Scores of multiple RSI items (persistent throat clearing， excessive sputum or nasal reflux， dyspnea or recurrent asphyxia， throat foreign body sensation) and RFS items (laryngeal mucus adhesion， diffuse laryngeal edema) were significantly lower than those before intervention， and the differences were highly statistically significant (P < 0.01). Conclusion Oral appliance is helpful for the treatment of OSAHS patients combined with LPR and can significantly relieve the symptoms of patients with LPR., http://www.100md.com(张小萍 陈桂 宋丽娟 张明)