阻塞性睡眠呼吸暂停中的器械疗法:系统性审查和元分析
Arushi Beri1, Sweta G Pisulkar2, Surekha A Dubey3
1Prosthodontics, Sharad Pawar Dental College and Hospital, Acharya Vinoba Bhave Rural Hospital (AVBRH), Wardha, IND.
Cureus
|December 7, 2023
概括
持续正气道压力 (CPAP) 在治疗阻塞性睡眠呼吸暂停 (OSA) 方面比口腔器械更有效. 然而,口腔器械,特别是下前进装置 (MAD),为轻度至中度OSA患者提供了有益的替代方案.
科学领域:
- 睡眠医学 睡眠医学
- 呼吸系统医学 呼吸系统医学
- 耳鼻喉科 耳鼻喉科 耳鼻喉科
背景情况:
- 阻塞性睡眠呼吸暂停 (OSA) 涉及睡眠期间的呼吸道阻塞,导致脱和健康问题.
- OSA与心血管问题和潜在的神经认知障碍有关.
- 器械治疗是OSA的关键治疗方式.
研究的目的:
- 系统地审查和评估用于阻塞性睡眠呼吸暂停 (OSA) 的器械治疗的有效性.
- 为了比较不同OSA器件的疗效,包括CPAP和口腔器件.
- 为了评估治疗结果,使用无呼吸低呼吸指数 (AHI).
主要方法:
- 1998年至2021年间发表的随机对照试验 (RCT) 的系统综述和元分析.
- 在Cochrane图书馆,PubMed和谷歌学者搜索相关研究.
- 使用Cochrane偏差风险和GRADE对结果的信心来评估研究质量.
主要成果:
- 持续正气道压力 (CPAP) 显著改善了AHI,比口腔器械更好.
- 与基线相比,口服器械 (OA) 治疗显著改善了AHI.
- 对于对CPAP无反应的轻度至中度OSA患者,MAD显示出潜在的益处.
结论:
- CPAP是轻度至中度OSA的黄金标准.
- 口腔器具对OSA有效,特别是在轻度至中度病例中,但不如CPAP有效.
- 对于特定的OSA患者亚组,MAD可能是一个有价值的替代方案.
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