【摘要】 目的对比手术前及手术后3个月上气道各段的容积,探讨正颌手术对骨性Ⅲ类错■畸形患者上气道容积的影响。方法选取16例成年骨性Ⅲ类错■畸形患者,分别在术前及术后3个月行颅面CT扫描,测量上气道各段容积变化量及上下颌骨咬合平面移动量,对上下颌骨咬合平面移动量与上气道各段容积的变化率进行Pearson相关分析。结果 16例患者术后均无呼吸窘迫症状。患者术后3个月时鼻段气道容积、腭段气道容积较术前显著增大(t=-4.389、-4.378,P<0.01),舌段气道容积、喉段气道容积及上气道总容积较术前显著减小(t=6.086～8.092,P<0.01);上颌骨咬合平面移动量与鼻段、腭段气道容积变化率呈正相关(r=0.862、0.816,P<0.05);下颌骨咬合平面移动量与舌段、喉段气道容积变化率呈正相关(r=0.869、0.914,P<0.05)。结论正颌手术可以导致骨性Ⅲ类错■畸形患者的上气道总容积减小,下颌骨咬合平面的移动量是正颌手术后上气道总容积变化的主要影响因素,该研究结果可以为该类患者正颌术的术前设计提供参考依据,以期可以预防患者医源性呼吸窘迫的发生。更多还原

【Abstract】 Objective To compare the volume of each segment of the upper airway before and 3 months after class Ⅲ skeletal malocclusion, and to investigate the effect of orthognathic surgery on the upper airway volume of patients with class Ⅲ skeletal malocclusion. Methods Sixteen adult patients with class Ⅲ skeletal malocclusion were selected. Craniofacial CT scan was performed before and 3 months after operation, and the change in the volume of each segment of the upper airway and the movement of maxillary and mandibular occlusal plane were measured and subjected to Pearson correlation analysis. ResultsNone of the 16 patients had respiratory distress. At 3 months after operation, the nasal airway volume and palatal airway volume increased significantly(t=-4.389,-4.378,P<0.01), while the lingual airway volume, laryngeal airway volume, and total upper airway volume decreased significantly(t=6.086-8.092,P<0.01). There was a positive correlation between the movement of maxillary occlusal plane and the change rates of nasal and palatal airway volumes(r=0.862,0.816,P<0.05), and there was a po-sitive correlation between the movement of mandibular occlusal plane and the change rates of lingual and laryngeal airway volumes(r=0.869,0.914,P<0.05). Conclusion Orthognathic surgery will reduce the total upper airway volume in patients with class Ⅲ skeletal malocclusion, and the movement of mandibular occlusal plane is the main factor affecting the change rate of total upper airway volume after orthognathic surgery. The results can provide a reference for preoperative design of the orthognathic surgery in patients with class Ⅲ skeletal malocclusion, so as to prevent iatrogenic respiratory distress.更多还原