儿童阻塞性睡眠呼吸暂停低通气综合征手术前后生活质量调查

Quality of life survey in children with obstructive sleep apnea hypopnea syndrome before and after operation

目的探讨阻塞性睡眠呼吸暂停低通气综合征(obstructive sleep apnea hypopnea syndrome,OSAHS)对儿童生活质量的影响,分析手术治疗前后生活质量的变化.方法在术前4周内对54例患儿进行儿童OSAHS疾病特异性生活质量调查(disease-specific quality of life for children with obstructive sleep apnea 18 items survey,OSA-18)和多导睡眠监测(polysomnography,PSG),并分析二者的相关性;其中单纯扁桃体切除术8例,扁桃体切除术+腺样体切除术32例,单纯腺样体切除术14例.在术后12～18个月进行生活质量随访.结果 OSAHS对61.11%患儿生活质量造成严重影响;手术前OSA-18评分与呼吸暂停低通气指数、最低血氧饱和度存在明显相关;手术后约75.92%的患儿生活质量得到明显改善,各项目依次为:睡眠障碍(88.89%)、对患儿监护人的影响(74.07%)和身体症状(70.37%).结论儿童OSAHS严重影响患儿的生活质量,OSA-18评分与PSG客观监测之间存在明显的相关关系,可作为儿童OSAHS临床诊断和疗效观察的评价指标.

s Objective To evaluate the influence of OSAHS in quality of life (QOL) for children and its changes before and after surgery. Methods Pediatric OSAHS disease-specific quality of life survey (OSA-18) and polysomnography (PSG) were used to analysis in 54 cases within 4 weeks before surgery. They were treated by tonsillectomy in 8 cases and adenoid tonsillectomy in 32 cases,adenoidectomy alone in 14 cases and were followed up in 12 to 18 months post-operation. Results The impact of pediatric OSAHS on QOL was severe in 61.11% patients. There were significant statistically correlation between OSA-18 and AHI,LSaO_2 before surgery. After surgery,the total scores of QOL were improved in 75.92% cases in general. The domains of sleep disturbance in 88.89% cases,caregiver concerns in 74.07% and physical suffering in 70.37% were significantly improved,respectively. Conclusions Pediatric OSAHS had severely influenced in quality of life of children. There are significant correlations between the survey in quality of life of pediatric OSAHS (OSA-18) and the objective data in PSG. OSA-18 can be a valuable measure in clinical diagnosis and treatment follow-up.