上颌快速扩弓在伴有上颌狭窄的儿童OSAHS治疗中的应用

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上颌快速扩弓在伴有上颌狭窄的儿童OSAHS治疗中的应用

作者：赵健等

来源：《中国医学创新》2014年第17期

【摘要】目的：探讨上颌快速扩弓（rapid maxillary expansion，RME）在伴有上颌狭窄的儿童阻塞性睡眠呼吸暂停低通气综合征（obstructive sleep apnea hypopnea syndrom，OSAHS）治疗中的效果。方法：本组25例患者，均为排除鼻、鼻咽、腭咽占位性阻塞病因的单纯性上颌狭窄的儿童OSAHS患者，年龄9～13岁，平均11岁，进行快速扩弓治疗。治疗前后进行多导睡眠监测（Polysomnography，PSG）、口腔锥体束CT（CBCT）检查，治疗效果视觉模拟

评分（visual analogue scale，VAS）。结果：所有患者牙弓宽度增加，对应鼻底宽度增加，腭后气道宽度增加，相应OSAHS主观及客观症状明显好转。结论：上颌快速扩弓可作为一种治疗伴有上颌狭窄的儿童OSAHS的治疗方法。

【关键词】上颌快速扩弓；上颌狭窄；阻塞性睡眠呼吸暂停低通气综合征；儿童

【Abstract】 Objective：To investigate the effect of rapid maxillary expansion in treatment of OSAHS of children only accompanied by maxillary stricture.Method：25 children with OSAHS who only accompanied by maxillary stricture except the other causes（except nose，nose pharynx and pharyngeal occupying obstructive causes） were investigated，the age was 9-13 years old，their average age was 11 years old.25 cases were treated by rapid maxillary expansion and underwent PSG and CBCT examination of pre and post treatment，VAS were evaluated after treatment.Result：The width of the dental arch width，the corresponding nasal base width and the retropalatal airway width of 25 cases all increased，the subjective and objective corresponding symptoms of all were markedly improved.Conclusion：Rapid maxillary expansion can be one treatment method of OSAHS of children only accompanied by maxillary stricture.

【Key words】 Rapid maxillary expansion； Maxillary stricture； Obstructive sleep apnea hypopnea syndrom； Children

临床发现，部分阻塞性睡眠呼吸暂停低通气综合征（obstructive sleep apnea hypopnea syndrom，OSAHS）患儿经过腺样体及扁桃体手术后，相应OSAHS症状仍存在，经分析考虑为张口呼吸引起的上颌狭窄所致。本研究运用上颌快速扩弓（rapid maxillary expansion，RME）治疗伴有上颌狭窄的OSAHS患者，OSAHS症状明显缓解，取得了满意疗效。现报告如下。

1 资料与方法