目的:评价可调式口腔矫治器治疗儿童阻塞性睡眠呼吸暂停综合征( OSAS)的疗效.方法: 45例 OSAS 患儿,采用多导睡眠仪监测戴用可调式口腔矫治器前后多项指标变化如:呼吸紊乱指数( AHI),呼吸暂停指数( AI),最低sao2和睡眠效率等指标并进行分析.结果:45例OSAS患儿AHI有效率(P＜0.01):10例轻度患儿为66.7% ,23例中度患儿为62.1%,12例重度患儿67.9%.AI有效率(P＜0.01):10例轻度患儿为61.5%,23例中度患儿有效率为69.6%,12例重度68.4%.最低sao2显著升高(P＜0.01):10例轻度患儿升高2.6% ,23例中度患儿升高8.5%,12例重度患儿16.5%.睡眠效率升高(P＜0.01):10例轻度患儿升高19.4 % ,23例中度患儿升高19.9%,12例重度患儿45.6%.患者睡眠质量均有显著改善,鼾声消失或明显减轻.结论:可调式口腔矫治器治疗儿童阻塞性睡眠呼吸暂停综合征( OSAS)疗效明显.

Objective:To evaluate the effectiveness of the treatment of adjustable oral appliances for children patients with obstructive sleep apnea syndrome(OSAS).Methods:45 cases of children patients with OSAS were used polysomnography to monitor changes of apnea hypopnea index(AHI),apnea index(AI),the lowest Sao2 and the efficiency of sleep before and after wearing adjustable oral appliance and then analyzed the changes.Results:The effective rate of AHI(P<0.01) in the 45 cases of children patients with OSAS:66.7% in the 10 cases of children patients with slight OSAS,62.1% in the 23 cases of children patients with moderate OSAS and 67.9% in the 12 cases of children patients with severe OSAS.The effective rate of AI(P<0.01):61.5% in the 10 cases of children patients with slight OSAS,69.6% in the 23 cases of children patients with moderate OSAS and 68.4% in the 12 cases of children patients with severe OSAS.The lowest Sao2 significantly increased(P<0.01):2.6% in the 10 cases of children patients with slight OSAS,8.5% in the 23 cases of children patients with moderate OSAS and 16.5% in the 12 cases of children patients with severe OSAS.The efficiency of sleep increased(P<0.01):19.4 % in the 10 cases of children patients with slight OSAS,19.9% in the 23 cases of children patients with moderate OSAS and 45.6% in the 12 cases of children patients with severe OSAS.All patients' quality of sleep improved significantly and their snoring disappeared or reduced significantly.Conclusion:The treatment of adjustable oral appliances in children patients with obstructive sleep apnea syndrome(OSAS) has a remarkable effect.

新生儿病房属于医院感染高危科室,由于新生儿免疫力低下、病情复杂、侵入性操作较多,因此,新生儿病房与医院感染相关的突发事件较多.笔者对某院新生儿病房(包括内外科)发生新生儿腹泻突发事件的流行病学进行调查,结果报道如下.

Objective:To investigate the changes and their trends of the upper airway and the surrounding structure when the children patients with obstructive sleep apnea syndrome(OSAS)advance their mandibula as they are treated by adjustable oral appliances.Method:Analyze by X-cephalometry before and after the treatment of adjustable oral appliances in 32 cases of children patients with obstructive sleep apnea syndrome.Result:In the 32 cases of children patients with OSAS,the distance of AH-MP reduced by 30.70 %;the distance of AH-Ge reduced by 10.38%;the distance of AH-CVP increased by 4.95 %;the distance of AH-PH reduced by 4.26%;the distance of V-T reduced by 5.32 %;the distance of SPP-SPPW increased by 27.04 %;the distance of U-MPW increased by 17.10 %;the distance of TB-TPPW increased by 20.68 %;the distance of V-LPW increased by 18.28 %;the distance of LPW-CVP reduced by 13.43 %;the distance of V-Ge increased by 18.27 %:all of them have statistical significance.Conclusion:The X-cephalometry has a significant value on the supplementary diagnosis,the treatment and the evaluation of the treatment when it is used to treat children patients with obstructive sleep apnea syndrome(OSAS).