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摘要目的：通过评估骨性Ⅲ错合畸形患者正颌手术后睡眠时期的呼吸功能情况，研究该类患者正颌手术后存在呼吸道梗阻的可能性。为临床治疗提供依据。方法：分析56例接受正颌手术的骨性Ⅲ类错合畸形患者的术前及术后1周、1 月、3 月和术后6月的多导睡眠图报告。设计问卷调查表评估手术影响日间嗜睡度的变化。从PSG 报告上获得的术前术后有代表性的2 项参数睡眠呼吸暂停低通气指数与最低氧饱和度分别进行比较。结果：数据显示术前和术后AHI指数及SpO2无显著性差异（统计学上无差异）。54 例病人术后均未出现睡眠呼吸障碍症状。2 例病人术后出现睡眠时期打鼾，但术后随访6月后打鼾逐渐消失。结论：骨性 Ⅲ类错合畸形患者正颌术后无明显呼吸道梗阻症状。但若患者同时具有超重、短颈、舌体大等其他危险因素及仅行下颌骨后退手术可能导致睡眠呼吸暂停低通气综合症的发生。

英文摘要:

ABSTRACT Objective：The aim of this study was to analyze the possibility of airway obstruction after orthognathic surgery for skeletal class Ⅲ malocclusions (mandibular prognathismwith maxillary retrognathism or not maxillary retrognathism). Provide the basis for clinical treatment. Methods：56 patients were analyzed using a 1 night sleep study for full Polysomnography（PSG）before preoperative 1 weeks and 1 weeks, 1 months, 3 months, 6 months after OS. A questionnaire was used to assess changes in daytime sleepiness. And apnea-hyponea index（AHI）and Average oxygen saturation（SaO2）index obtained from the PSG report before and after operation were separately compared. Results：The data of preoperative and postoperative show that AHI index and SpO2 had no significant difference (no statistically difference). In 54 patients after operation showed no symptoms of sleep-disordered breathing. 2 patients with postoperative sleep period snoring, but postoperative follow-up snoring disappeared gradually after 6 months.Conclusion： No obvious symptoms of airway obstruction in patients with skeletal class Ⅲ malocclusions after orthognathic surgery. But if the patients with overweight, short neck, tongue and other risk factors and only a mandibular setback operation may lead to the occurrence of Obstructive sleep apnea hypopnea syndrome(OSAHS).

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