儿童阻塞性睡眠呼吸暂停低通气综合征的手术治疗

Efficacy of tonsillectomy and adenoidectomy in childhood obstructive sleep apnea hypopnea syndrome

目的探讨扁桃体、腺样体切除术对儿童阻塞性睡眠呼吸暂停低通气综合征(OSAHS)的疗效。方法通过分析96例儿童OSAHS的临床资料,采用扁桃体切除术和/或腺样体切除术,并对其中36例患儿术前、术后多导睡眠仪监测结果比较分析。结果96例患儿,临床治愈76例,有效15例,无效5例,有效率94.8%。其中36例患儿术后呼吸暂停低通气指数(AHI)、最低血氧饱和度及血氧饱和度低于0.90占睡眠时间的百分比与术前比较均有显著差异。结论扁桃体和/或腺样体肥大是儿童OSAHS的主要病因,手术切除是首选的治疗方法,多导睡眠仪监测是诊断和判定疗效的标准。

Objective To evaluate the efficacy of tonsillectomy and adenoidectomy in childhood obstructive apnea hypopnea syndrome（OSAHS）, Methods The medical data of 96 children with OSAHS were retrospectively reviewed. Tonsillectomy and adenoidectomy were performed for all patients. 36 cases of OSAHS were monitored with polysomnography （PSG） ,and the parameters obtained before and after operation were analyzed. Results It was found that 76 cases were cured （79,2 %）, 15 cases achieved symptomatic relief （15.6%）.5 cases remained failure （5.2%）,and the total effective rate was 94.8%. The mean values of the PSG parameters in 36 cases were follows ：the apnea hypopnea index （AHI）,the lowest pulse oxygen saturation （SPO2）,and SPO2〈0.90 time during sleep. Compared with preoperation groups there was a statistically significant difference（P〈0.01）. Conclusion Adenoidal hypertrophy seemed to be an important cause of OSAHS in children. Surgery is the important mean to cure OSAHS. Confirmed diagnosis of childhood OSAHS requires PSG recordings.