口服器械对轻度,中度和重度阻塞性睡眠呼吸暂停的有效性:一个元分析
Jianhong Liao1,2,3, Yunhan Shi1,2,3, Xiang Gao1,2,3
1Department of Sleep Medical Center, Beijing Tongren Hospital, Capital Medical University, Beijing, China.
概括
口腔器械,如下前进装置 (MAD) 和舌头保留装置 (TRD),有效地治疗中度至严重的阻塞性睡眠呼吸暂停 (OSA). MAD在轻度OSA中显示出有效性,而TRD需要更多的研究.
科学领域:
- 睡眠医学 睡眠医学
- 呼吸系统医学 呼吸系统医学
- 医疗器械 医疗器械
背景情况:
- 口腔器械 (OA) 是对轻度至中度阻塞性睡眠呼吸暂停 (OSA) 的一线治疗方法.
- 在不同严重程度的OSA中比较OA有效性的证据是有限的.
- 这项研究评估了在不同严重程度的OSA中使用的舌头保留装置 (TRD) 和下前进装置 (MAD).
研究的目的:
- 在患有轻度,中度和重度阻塞性睡眠呼吸暂停 (OSA) 的患者中,比较首选口腔器械 (TRD和MAD) 的治疗效果.
- 根据OSA的严重程度,分析不同类型的口腔器械的疗效.
主要方法:
- 42项涉及2265名患者的研究的系统综述和元分析.
- 在PubMed/MEDLINE,科克伦图书馆和科学网上搜索到2022年11月10日.
- 遵循系统审查和元分析 (PRISMA) 准则的首选报告项目.
主要成果:
- 呼吸暂停-呼吸暂停指数在轻度改善了48%,中度改善了67%,严重的OSA改善了62%.
- 部推进装置 (MAD) 在轻微的OSA中显示出明显高于舌头保留装置 (TRD) 的疗效 (58%对21%).
- 在中度 (67%对66%) 和严重的OSA (66%对51%),没有观察到MAD和TRD之间的有效性有显著差异.
- 在爱普沃思睡眠量表,氧气不和指数 (ODI) 或最低氧气和指数 (LSAT) 中,两组之间没有发现显著差异.
结论:
- TRD和MAD都是适度至重度OSA的有效治疗方法.
- 对于轻度的OSA,MAD是有效的,而TRD则需要进一步验证.
- 在轻度中度和重度OSA患者中,睡眠,ODI和LSAT的改善类似.
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