CN100486545C - Curative effect prejudging system of oral cavity corrector for obstructive sleep apnea patient - Google Patents

Abstract

Translated fromChinese

本发明公开了一种阻塞性睡眠呼吸暂停患者口腔矫治器疗效预判系统，包括用于监测患者睡眠质量的多导睡眠监测仪和临时性口腔矫治器，还包括一个传动装置和一个计算机控制部分，所述临时性口腔矫治器分为上颌部分和下颌部分，分别连接在传动装置上，计算机控制部分与传动装置通过导线相连。本发明采用计算机来自动控制患者的下颌前伸位置，并结合多导睡眠监测仪的监测结果，可以初步判断口腔矫治器的疗效并寻找到最适合的下颌前伸位置，并且为研究阻塞性睡眠呼吸暂停患者下颌前伸定位与睡眠呼吸功能改善的相关性提供了平台。

The invention discloses a curative effect prediction system of an oral appliance for patients with obstructive sleep apnea, which includes a polysomnography monitor and a temporary oral appliance for monitoring the sleep quality of the patient, and also includes a transmission device and a computer control part , the temporary oral appliance is divided into a maxillary part and a mandibular part, which are respectively connected to the transmission device, and the computer control part is connected to the transmission device through wires. The present invention uses a computer to automatically control the patient's mandibular protruding position, combined with the monitoring results of the polysomnography instrument, can preliminarily judge the curative effect of the oral appliance and find the most suitable mandibular protruding position, and provide a basis for the study of obstructive sleep disorders. Correlation of mandibular protraction positioning with improved sleep breathing function in apneic patients provides a platform.

Description

Translated fromChinese

阻塞性睡眠呼吸暂停患者口腔矫治器疗效预判系统Oral appliance efficacy prediction system for patients with obstructive sleep apnea

技术领域technical field

本发明涉及一种口腔医学、睡眠医学和呼吸内科学中的计算机控制应用系统，特别是一种用于研究下颌前伸位置对阻塞性睡眠呼吸暂停患者睡眠呼吸影响的计算机辅助系统。The invention relates to a computer control application system in stomatology, sleep medicine and respiratory medicine, in particular to a computer-aided system for studying the effect of mandibular protruding position on sleep respiration of patients with obstructive sleep apnea.

背景技术Background technique

阻塞性睡眠呼吸暂停是一种常见病，好发年龄为40-60岁，中年男性的发病率是4％，中年女性的发病率是2％。该病主要表现为睡眠时反复发作的上气道狭窄或阻塞，导致血氧饱和度降低，睡眠结构紊乱，形成心、脑、肺、肾、内分泌紊乱等一系列系统的并发症，甚至猝死。Obstructive sleep apnea is a common disease, the age of onset is 40-60 years old, the incidence rate of middle-aged men is 4%, and the incidence rate of middle-aged women is 2%. The disease mainly manifests as recurrent upper airway stenosis or obstruction during sleep, leading to decreased blood oxygen saturation, sleep structure disorder, heart, brain, lung, kidney, endocrine disorders and a series of systemic complications, and even sudden death.

口腔矫治器是一种常用的治疗阻塞性睡眠呼吸暂停的医疗器械，它的作用原理是：睡眠时强制下颌向前伸，改变下颌、舌、软腭及腭垂的位置关系，稳定下颌和舌，增加舌肌张力，从而达到开大和稳定气道的目的。能否为每一个患者确定一个合适的前伸位置，会直接影响口腔矫治器的治疗效果。Oral appliance is a commonly used medical device for the treatment of obstructive sleep apnea. Its function principle is to force the mandible to protrude forward during sleep, change the positional relationship of the mandible, tongue, soft palate and palate, and stabilize the mandible and tongue. Increase tongue muscle tension, so as to achieve the purpose of opening and stabilizing the airway. Whether a suitable forward position can be determined for each patient will directly affect the therapeutic effect of the oral appliance.

但是迄今为止，还没有一种科学有效的手段，可以为每个患者确定其最佳的前伸位置。目前，临床上通常采用的下颌前伸位置是患者下颌最大前伸距离的60-70％，但这个位置的确定具有很大的盲目性，因为该结果未与多导睡眠监测相结合，因而无从得知在这一位置上患者病情的改善程度。这样可能造成为不适合口腔矫治器治疗的患者制作了口腔矫治器，未达到治疗目的却加重了患者的经济负担；即使患者适合用口腔矫治器治疗，也不能确定口腔矫治器的最适下颌前伸位置，下颌前伸过多不但会增加患者面部肌肉的不适而且增加颞下颌关节紊乱发生的可能性，下颌前伸不足则不能完全发挥口腔矫治器的疗效。But so far, there is no scientifically valid means to determine the optimal protraction position for each patient. At present, the commonly used mandibular protruding position is 60-70% of the maximum protruding distance of the patient's mandibular, but the determination of this position is blinded, because the results are not combined with polysomnography, so there is no way to know. Learn how much the patient's condition improves in this position. This may result in the manufacture of oral appliances for patients who are not suitable for oral appliance treatment, which does not achieve the purpose of treatment but increases the economic burden of the patient; even if the patient is suitable for oral appliance treatment, the optimal mandibular front of the oral appliance cannot be determined Excessive mandibular protraction will not only increase the discomfort of the patient's facial muscles but also increase the possibility of temporomandibular joint disorders. Insufficient mandibular protraction will not fully exert the efficacy of the oral appliance.

现今研究下颌位置对于阻塞性睡眠呼吸暂停患者的睡眠影响一般仅局限于某一个下颌位置；即使是取不同的下颌位置，研究也是在不同的夜晚进行，这样不仅需要做几个临时性的矫治器，而且不同夜晚睡眠情况的可比性较差；如果是在同一晚上取下颌的不同前伸位置，通常需要几次唤醒患者，不但监测的医生整夜无法入睡，患者的睡眠也受到影响，而且由于干扰了患者的正常睡眠，所得结果难以说明其真实情况。Nowadays, research on the effect of jaw position on sleep in patients with obstructive sleep apnea is generally limited to a certain jaw position; even if different jaw positions are taken, the research is carried out on different nights, which not only requires several temporary appliances , and the comparability of sleep conditions at different nights is poor; if different protruding positions of the mandible are taken at the same night, the patient usually needs to be woken up several times. Interfering with the patient's normal sleep, the results obtained are difficult to explain their true condition.

发明内容Contents of the invention

本发明要解决的技术问题是提供一种口腔矫治器疗效预判系统，利用该系统可以自动“滴定”患者的下颌前伸位置并同时进行多导睡眠监测，进行疗效判断。从而为拟采用口腔矫治器治疗的患者确定最适的下颌前伸位置。The technical problem to be solved by the present invention is to provide an oral appliance curative effect prediction system, which can automatically "titrate" the mandibular protruding position of the patient and simultaneously perform polysomnography to judge the curative effect. In order to determine the optimal mandibular protrusion position for patients who are to be treated with oral appliances.

为解决上述技术问题，本发明采用如下技术方案：一种阻塞性睡眠呼吸暂停患者口腔矫治器疗效预判系统，包括用于监测患者睡眠质量的多导睡眠监测仪和临时性口腔矫治器，还包括一个传动装置和一个计算机控制部分，所述临时性口腔矫治器分为上颌部分和下颌部分，分别连接在传动装置上，计算机控制部分与传动装置通过导线相连。In order to solve the above technical problems, the present invention adopts the following technical solutions: a system for predicting the curative effect of oral appliances for patients with obstructive sleep apnea, including polysomnography and temporary oral appliances for monitoring the sleep quality of patients, and It includes a transmission device and a computer control part. The temporary oral appliance is divided into an upper jaw part and a lower jaw part, which are respectively connected to the transmission device. The computer control part is connected with the transmission device through wires.

在上述技术方案中，传动装置可采用如下结构：由步进电机、螺杆、螺杆支架、螺母和螺母支架组成，步进电机固定在螺杆支架上，螺杆的一端与步进电机的轴联接，另一端支承在螺杆支架的轴孔中，螺母套装在螺杆上，螺母支架铰接在螺母上。所述螺杆支架、螺母支架分别与口腔矫治器的上颌部分、下颌部分相连接。In the above technical solution, the transmission device can adopt the following structure: it is composed of a stepping motor, a screw, a screw bracket, a nut and a nut bracket, the stepping motor is fixed on the screw bracket, one end of the screw is connected to the shaft of the stepping motor, and the other One end is supported in the shaft hole of the screw rod bracket, the nut is sleeved on the screw rod, and the nut bracket is hinged on the nut. The screw bracket and the nut bracket are respectively connected with the upper jaw part and the lower jaw part of the oral appliance.

在上述技术方案中，计算机控制部分可以由计算机、单片机和驱动电路组成，计算机通过串口与单片机连接，单片机通过驱动电路与位置调节器相连接。In the above technical solution, the computer control part can be composed of a computer, a single-chip microcomputer and a driving circuit, the computer is connected to the single-chip microcomputer through a serial port, and the single-chip microcomputer is connected to the position regulator through the driving circuit.

在上述技术方案中，临时性口腔矫治器最好由温敏塑料制成，或用自凝塑料结合前磨牙箭头卡环制成。In the above technical solution, the temporary oral appliance is preferably made of temperature-sensitive plastic, or made of self-curing plastic combined with a premolar arrow snap ring.

上述传动装置的螺杆最好由聚四氟乙烯制成，螺母由铝制成。从而减小摩擦，提高效能。The screw rod of the above-mentioned transmission device is preferably made of polytetrafluoroethylene, and the nut is made of aluminum. Thereby reducing friction and improving performance.

上述传动装置的步进电机转速不可太快，其带动下颌前伸的速度最好控制在0.2mm/s左右，移动精度±0.01mm，下颌总移动范围控制在20mm以内。The speed of the stepper motor of the above-mentioned transmission device should not be too fast, and the speed at which it can drive the mandible to protrude is best controlled at about 0.2mm/s, the movement accuracy is ±0.01mm, and the total movement range of the mandible is controlled within 20mm.

由于本发明的技术方案，采用了计算机自动控制患者的下颌前伸位置，并结合多导睡眠监测仪，通过逐步“滴定”的方式，可以初步判断口腔矫治器疗效并寻找到最适合的下颌前伸位置。同时该系统为研究阻塞性睡眠呼吸暂停患者下颌前伸定位与睡眠呼吸功能改善的相关性提供了平台。在研究过程中不需要更换临时性口腔矫治器，不会干扰患者的正常睡眠，既减轻了患者的痛苦，也使监测的结果更加真实可靠。由于计算机可以自动控制位置调节器的运动，并能同时记录监测的结果，负责监测的医生也无需整夜值守，也减轻了医生的工作强度。Due to the technical solution of the present invention, a computer is used to automatically control the patient's mandibular protruding position, combined with polysomnography, through a step-by-step "titration" method, the curative effect of the oral appliance can be preliminarily judged and the most suitable mandibular protruding position can be found. extended position. At the same time, the system provides a platform for studying the correlation between mandibular protraction positioning and improvement of sleep breathing function in patients with obstructive sleep apnea. During the research process, there is no need to replace the temporary oral appliance, and it will not interfere with the normal sleep of the patient, which not only reduces the pain of the patient, but also makes the monitoring results more real and reliable. Since the computer can automatically control the movement of the position regulator and record the monitoring results at the same time, the doctor in charge of monitoring does not need to be on duty all night, which also reduces the work intensity of the doctor.

附图说明Description of drawings

图1是本发明的系统组成框图。Fig. 1 is a system block diagram of the present invention.

图2是本发明的传动装置的结构示意图。Fig. 2 is a structural schematic diagram of the transmission device of the present invention.

具体实施方式Detailed ways

以下结合附图和具体实施方式对本发明做进一步说明。The present invention will be further described below in conjunction with the accompanying drawings and specific embodiments.

如图1所示，计算机与单片机相连接，单片机通过驱动电路可以控制步进电机运动，步进电机的运动通过传动装置转化为临时性口腔矫治器上下颌两部分之间的相对移动。多导睡眠监测仪也与计算机相连接，其监测结果由计算机显示和记录。As shown in Figure 1, the computer is connected to the single-chip microcomputer, and the single-chip microcomputer can control the movement of the stepping motor through the driving circuit, and the movement of the stepping motor is converted into the relative movement between the upper and lower jaws of the temporary oral appliance through the transmission device. The polysomnography monitor is also connected with the computer, and the monitoring results are displayed and recorded by the computer.

如图2所示，传动装置的步进电机1固定在螺杆支架2上，临时性口腔矫治器的上颌部分6通过镶嵌在其中的螺钉固定在螺杆支架2上，位置是固定的。临时性口腔矫治器的下颌部分7通过镶嵌在其中的螺钉固定在螺母支架5上，螺母支架5铰接在螺母4上，步进电机1可以带动由聚四氟乙烯制成的螺杆3转动，螺杆3的转动使其上的螺母4发生线性位移，从而带动临时性口腔矫治器的下颌部分7移动。这样，步进电机的转动就转化为临时性口腔矫治器的下颌部分7与上颌部分6之间的相对移动。As shown in Figure 2, thestepper motor 1 of the transmission device is fixed on thescrew bracket 2, and themaxillary part 6 of the temporary oral appliance is fixed on thescrew bracket 2 by the screws embedded therein, and the position is fixed. The mandibular part 7 of the temporary oral appliance is fixed on the nut bracket 5 by the screw embedded therein, the nut bracket 5 is hinged on the nut 4, thestepper motor 1 can drive thescrew rod 3 made of polytetrafluoroethylene to rotate, the screw rod The rotation of 3 makes the nut 4 on it linearly displaced, thereby driving the lower jaw part 7 of the temporary oral appliance to move. In this way, the rotation of the stepping motor is transformed into the relative movement between the lower jaw part 7 and theupper jaw part 6 of the temporary oral appliance.

患者在睡觉前，将临时性口腔矫治器戴入口中，临时性口腔矫治器的上颌部分6固定上颌牙齿上，下颌部分7固定在下颌牙齿上。这样，临时性口腔矫治器的相对移动就会带动患者的下颌位置发生变化。并要通过计算机控制测定患者的下颌最大前伸位置。然后将多导睡眠监测仪也连接好，用于同步监测患者的睡眠质量。Before going to bed, the patient wears the temporary oral appliance in the mouth, theupper part 6 of the temporary oral appliance is fixed on the upper teeth, and the lower part 7 is fixed on the lower teeth. In this way, the relative movement of the temporary oral appliance will drive the position of the patient's jaw to change. And the maximum protruding position of the patient's mandible should be determined through computer control. Then the polysomnography is also connected to monitor the patient's sleep quality simultaneously.

通过多导睡眠图判断患者入睡一小时后，操作者再次打开计算机上的控制程序，使患者下颌定时定程前伸输入的距离(如每小时前伸2mm)，并输入患者下颌的最大前伸距离，以防止睡眠过程中该装置使患者下颌前伸得过多，损伤其颞下颌关节。这样计算机会将输入的控制指令传递给单片机，由单片机和驱动电路控制位置调节器的步进电机作步进运动，带动临时性口腔矫治器的下颌部分7移动，使患者的下颌移动到指定位置，并且同时由多导睡眠监测仪记录下在相应位置时患者的睡眠状况。下颌前伸的速度为0.2mm/s左右，移动精度±0.01mm。通过一整夜的下颌前伸定位睡眠监测，操作者可以在计算机上分析患者下颌处于不同位置时睡眠呼吸指标(如呼吸紊乱指数，缺氧指数，最低血氧饱和度，等)的变化，从而判断口腔矫治器的疗效并确定最适下颌前伸位置，而且可以进行下颌定位研究。After judging by polysomnography that the patient has fallen asleep for one hour, the operator opens the control program on the computer again to make the patient protrude the mandible at a fixed time and input the distance (such as protruding 2 mm per hour), and input the maximum protruding mandible of the patient To prevent the device from protruding the patient's jaw too much during sleep and damaging the temporomandibular joint. In this way, the computer will transmit the input control command to the single-chip microcomputer, and the stepping motor of the position regulator is controlled by the single-chip microcomputer and the driving circuit to make a stepping motion, which drives the lower jaw part 7 of the temporary oral appliance to move, so that the patient's lower jaw moves to the designated position , and at the same time, the sleep status of the patient in the corresponding position is recorded by the polysomnography. The speed of mandibular extension is about 0.2mm/s, and the movement accuracy is ±0.01mm. Through the sleep monitoring of mandibular protraction positioning throughout the night, the operator can analyze the changes of sleep breathing indicators (such as respiratory disorder index, hypoxia index, minimum blood oxygen saturation, etc.) when the patient's mandible is in different positions on the computer, thereby Judging the efficacy of oral appliances and determining the optimal mandibular protrusion position, and mandibular positioning studies can be performed.

Claims (5)

Translated fromChinese

1、一种阻塞性睡眠呼吸暂停患者口腔矫治器疗效预判系统，包括用于监测患者睡眠质量的多导睡眠监测仪和临时性口腔矫治器，其特征在于：还包括一个传动装置和一个计算机控制部分，所述临时性口腔矫治器分为上颌部分和下颌部分，分别连接在传动装置上，计算机控制部分与传动装置通过导线相连，所述传动装置由步进电机(1)、螺杆(3)、螺杆支架(2)、螺母(4)和螺母支架(5)组成，所述步进电机(1)固定在螺杆支架(2)上，所述螺杆(3)的一端与步进电机(1)的轴联接，另一端支承在螺杆支架(2)的轴孔中，所述螺母(4)套装在螺杆(3)上，所述螺母支架(5)铰接在螺母(4)上，所述螺杆支架(2)、螺母支架(5)分别与口腔矫治器的上颌部分(6)、下颌部分(7)相连接。1. An oral appliance curative effect prediction system for patients with obstructive sleep apnea, including polysomnography and temporary oral appliance for monitoring the sleep quality of patients, characterized in that: it also includes a transmission device and a computer The control part, the temporary oral appliance is divided into the upper jaw part and the lower jaw part, respectively connected to the transmission device, the computer control part is connected with the transmission device through wires, and the transmission device is composed of a stepping motor (1), a screw rod (3 ), screw support (2), nut (4) and nut support (5), the stepping motor (1) is fixed on the screw support (2), and one end of the screw (3) is connected to the stepping motor ( 1), the other end is supported in the shaft hole of the screw bracket (2), the nut (4) is sleeved on the screw (3), and the nut bracket (5) is hinged on the nut (4), so The screw bracket (2) and the nut bracket (5) are respectively connected with the upper jaw part (6) and the lower jaw part (7) of the oral appliance.2、根据权利要求1所述的阻塞性睡眠呼吸暂停患者口腔矫治器疗效预判系统，其特征在于：所述计算机控制部分包括计算机、单片机和驱动电路，所述计算机通过串口与单片机连接，所述单片机通过驱动电路与位置调节器相连接。2. The curative effect prediction system for oral appliances for patients with obstructive sleep apnea according to claim 1, characterized in that: the computer control part includes a computer, a single-chip microcomputer and a driving circuit, and the computer is connected to the single-chip microcomputer through a serial port. The single chip microcomputer is connected with the position regulator through the driving circuit.3、根据权利要求1所述的阻塞性睡眠呼吸暂停患者口腔矫治器疗效预判系统，其特征在于：所述临时性口腔矫治器由温敏塑料制成，或用自凝塑料结合前磨牙箭头卡环制成。3. The curative effect prediction system for oral appliances for patients with obstructive sleep apnea according to claim 1, characterized in that: the temporary oral appliance is made of temperature-sensitive plastic, or self-setting plastic combined with premolar arrows Snap ring made.4、根据权利要求1所述的阻塞性睡眠呼吸暂停患者口腔矫治器疗效预判系统，其特征在于：所述螺杆(3)由聚四氟乙烯制成，所述螺母(4)由铝制成。4. The curative effect prediction system for oral appliances for patients with obstructive sleep apnea according to claim 1, characterized in that: the screw (3) is made of polytetrafluoroethylene, and the nut (4) is made of aluminum become.5、根据权利要求1所述的阻塞性睡眠呼吸暂停患者口腔矫治器疗效预判系统，其特征在于：所述步进电机控制下颌前伸的速度为0.2mm/s左右，移动精度±0.01mm，下颌总移动范围20mm。5. The curative effect prediction system for oral appliances for patients with obstructive sleep apnea according to claim 1, characterized in that: said stepping motor controls the speed of mandibular protraction to be about 0.2mm/s, and the movement accuracy is ±0.01mm , The total movement range of the mandible is 20mm.

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