Chang Edward T, Fernandez-Salvador Camilo, Giambo Jeremy, Nesbitt Blaine, Liu Stanley Yung-Chuan, Capasso Robson, Kushida Clete A, Camacho Macario
Department of Otolaryngology, Division of Sleep Surgery and Medicine, Tripler Army Medical Center, HI, USA.
Uniformed Services University of the Health Sciences, School of Medicine, Bethesda,MD 20814, USA.
Am J Otolaryngol. 2017 May-Jun;38(3):272-278. doi: 10.1016/j.amjoto.2017.01.006. Epub 2017 Jan 18.
Tongue Retaining Devices (TRD) anteriorly displace the tongue with suction forces while patients sleep. TRD provide a non-surgical treatment option for patients with Obstructive Sleep Apnea (OSA). Our objective was to conduct a systematic review of the international literature for TRD outcomes as treatment for OSA.
Three authors independently and systematically searched four databases (including PubMed/MEDLINE) through June 26, 2016. We followed guidelines set within the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA).
Sixteen studies with 242 patients met criteria. The overall means±standard deviations (M±SD) for apnea-hypopnea index (AHI) decreased from 33.6±21.1/h to 15.8±16.0/h (53% reduction). Seven studies (81 patients) reported lowest oxygen saturation (LSAT), which improved from 79.8±17.5% to 83.9±8.6%. Four studies (93 patients) reported Epworth sleepiness scale (ESS), which decreased from 10.8±4.8 to 8.2±4.5, p <0.0001. Four studies (31 patients) reported Oxygen Desaturation Index (ODI) which decreased from 29.6±32.1 to 12.9±8.7, a 56.4% reduction.
Current international literature demonstrates that tongue retaining devices reduce apnea-hypopnea index by 53%, increase lowest oxygen saturation by 4.1 oxygen saturation points, decrease oxygen desaturation index by 56% and decrease Epworth sleepiness scale scores by 2.8 points. Tongue retaining devices provide a statistically effective alternative treatment option for obstructive sleep apnea.
舌保持装置（TRD）在患者睡眠时通过吸力使舌头向前移位。TRD为阻塞性睡眠呼吸暂停（OSA）患者提供了一种非手术治疗选择。我们的目的是对关于TRD治疗OSA疗效的国际文献进行系统综述。
三位作者独立且系统地检索了截至2016年6月26日的四个数据库（包括PubMed/MEDLINE）。我们遵循系统评价和Meta分析的首选报告项目（PRISMA）中规定的指南。
16项研究共242例患者符合标准。呼吸暂停低通气指数（AHI）的总体均值±标准差（M±SD）从33.6±21.1次/小时降至15.8±16.0次/小时（降低了53%）。7项研究（81例患者）报告了最低血氧饱和度（LSAT），其从79.8±17.5%提高至83.9±8.6%。4项研究（93例患者）报告了爱泼沃斯嗜睡量表（ESS），其从10.8±4.8降至8.2±4.5，p<0.0001。4项研究（31例患者）报告了氧减饱和度指数（ODI），其从29.6±32.1降至12.9±8.7，降低了56.4%。
当前国际文献表明，舌保持装置可使呼吸暂停低通气指数降低53%，使最低血氧饱和度提高4.1个百分点，使氧减饱和度指数降低56%，并使爱泼沃斯嗜睡量表评分降低2.8分。舌保持装置为阻塞性睡眠呼吸暂停提供了一种具有统计学意义的有效替代治疗选择。
