儿童阻塞性睡眠呼吸暂停低通气综合征手术治疗临床分析

Clinical analysis of the surgical treatment of obstructive sleep apnea hypopnea syndrome in children

目的:探讨儿童阻塞性睡眠呼吸暂停低通气综合征(OSAHS)手术治疗特点及其临床特征。方法:总结41例OSAHS患儿术前鼻咽侧位X线片(CR)、纤维鼻咽镜检查及多道睡眠监测(PSG)的特点,评价对其进行扁桃体和(或)腺样体手术治疗的效果。结果:41例患儿经扁桃体和(或)腺样体切除术后,睡眠鼾声明显减轻或消失,呼吸暂停消失或时间缩短并开始闭口呼吸,临床症状明显缓解。术后1～2月复查PSG,各项指标:AHI、最低血氧饱和度、最长呼吸暂停时间等,较术前有明显改善。结论:手术切除扁桃体和(或)腺样体,是治疗儿童OSAHS的有效手段,其诊断和手术方法的选择有赖于对PSG、鼻咽侧位X线片、纤维鼻咽镜检查和临床表现的综合考虑。

Objective： To investigate the clinical features and surgical treatment of pediatric obstructive sleep apnea hypopnea syndrome （0SAHS） in children. Methods： Forty- one cases diagnosed as 0SAHS by cephalometric, fibrorhinopharyngescopy and overnight polysomnography （PSG） were reviewed with clinical features. 41 cases were performed tonsillectomy and/or adenoidectomy and results were analysed. Results： The clinical symptoms of 41 cases improved evidently after operations including snoring in sleep, apnea, breathing opening mouth. In 1 -2 months after surgery, PSG were checked again： AHI, the lowest oxygen saturation, the longest time of apnea were im- proved than those of pre -operation. Conclusion： Surgical removal of upper airway obstruction caused by enlargement of tonsil and adenoid is one of the most effective treatment for pediatric 0SAHA. The diagnosis and treatment must be combined clinical feature with all kinds of examinations including PSG, cephalometric and fibrorhinopharyngescopy.