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儿童睡眠呼吸障碍与口腔医学治疗

Pediatric sleep-disordered breathing and oral medicine

作者:高雪梅

Author:Gao Xuemei

收稿日期:          年卷(期)页码:2014,32(4):319-319-322

期刊名称:华西口腔医学杂志

Journal Name:West China Journal of Stomatology

关键字:儿童睡眠呼吸暂停,口腔矫治器,生长发育,

Key words:pediatricsleep-disorderedbreathing,oralappliance, growthanddevelopment,

基金项目:

国家自然科学基金资助项目(30872915);首都医学发展科研基金资助项目(2007-3009)

中文摘要

儿童阻塞性睡眠呼吸暂停低通气综合征(OSAHS),系因儿童上气道狭窄夜间反复阻塞而影响血氧交换。由于夜间缺氧对生长发育的损害,将影响睡眠期间生长激素分泌、脑皮层的休眠及活动,对体格发育、精神行为、学习能力、性格养成均有不利影响,是医学领域重要的交叉学科内容,但尚存许多研究空白。口腔医学的介入,一方面以口腔医学特殊手段,如头影测量等,开展 OSAHS患儿的颅面形态诊断和分析,并能够实现对上气道生长发育的追踪观察;另一方面能够提供多种改善睡眠呼吸、改善因睡眠呼吸障碍导致的牙颌面畸形的治疗手段,较为典型的有下颌前导、横向扩弓和上颌前方牵引。口腔医学对符合条件的 OSAHS儿童开展治疗,是对腺体手术疗法的重要补充,纠正睡眠呼吸障碍带来的并发症,此外还可以探讨对成人OSAHS的预防。

英文摘要

Pediatric sleep-disordered breathing, also known as obstructive sleep apnea and hypopnea syndrome (OSAHS) in children, is caused by obstruction of upper airway, characterized by repetitive pauses in breathing during sleep despite the effort to breathe, and usually leads to reduction in oxygen saturation. Due to the importance of sufficient oxygen in growth and development, many children patients suffer from abnormal secretion of growth hormone at night, and also their activity and resting of cerebral cortex during sleep. Therefore, they face great risks in keeping normal physical growth, forming mental behavior, buildingup learning abilityandshaping personalities. It is a very importantinterdisciplinary subject, yet stillmuch remains unclear about the disease. Oral medicine is one of the subjects that show increasing importance in prevention and treatment of OSAHS in children. On one hand, due to the special means of the field, such as cephalometric, it can diagnose and monitor the development of craniofacial structures, especially the upper airway. On the other hand, it can provide treat-ments which can both improve breath during sleep and consequent dental facial deformities. Most typical treatments include mandibular sagittal growth stimulation, transverse maxillary palatal expansion and maxillary protraction. Oral medicine pro-vides additional treatment apart from traditional adenectomy and tonsilectomy to improve ventilation. It not only directly helps to improve deformities caused by sleep-disordered breathing in OSAHS children with indications, but also helps to avoid many of physical and mental complications, which will in turn benefit their life quality. Also, it may prospectively provide insights in treatment and prevention ofOSAHS in adults.

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