腺样体、扁桃体切除术对超重的阻塞性睡眠呼吸暂停综合征患儿影响

Adenotonsillectomy for obstructive sleep apnea in overweight children

目的探讨腺样体和扁桃体手术在改善超重的阻塞性睡眠呼吸暂停低通气综合征患儿睡眠呼吸质量的意义。方法分析56例超重的阻塞性睡眠呼吸暂停低通气综合征患儿术前、术后多导睡眠监测结果及临床症状,比较主要睡眠监测参数及其临床症状之间的差别;评判腺样体和扁桃体手术对本组患儿的治疗效果。结果患儿在腺样体和扁桃体手术后,睡眠呼吸障碍得到明显改善,术后睡眠呼吸暂停低通气综合征(AHI)均值4.85/h,较术前明显改善(P=0.001),有29例患儿(占52%)在术后睡眠呼吸障碍得到完全改善(AHI<5/h),55例患儿(占98%)在术后打鼾症状消失或减轻。有1例患儿因术后睡眠呼吸障碍未改善,予以夜间持续经鼻正压通气治疗。结论对于超重的阻塞性睡眠呼吸暂停低通气综合征患儿,腺样体和扁桃体切除术同样能得到很好的治疗效果。对于一些手术治疗效果差的患儿,持续经鼻正压通气等辅助治疗手段可作为必要的补充,使治疗手段更加全面。

Objective To evaluate the effect of adenotonsillectomy（T＆A） for the overweight obstructive sleep apnea hypopnea syndrome（OSAHS） children, Methods There were 56 overweight OSAHS children included in this study. We compared the main polysomnography（PSG） parameters between pre and post T＆A. Results Most of patients were improved after T＆A. The mean of apnea hypopnea index（AHI） after T ＆A was 4.85/h, representing a marked improvement than pre-operation （P = 0. 001 ）. 29 patients （52 % ） were improved completely after the operation（AHI〈 5）. 55 patients （98 % ） were not snoring after T ＆ A. Only one patient had,not improved after the operation. Nasal continuous positive airway pressure（nCPAP）were used to him. Conclusion T＆A is a useful treatment to the overweight OSAHS patients, nCPAP could be use for some special overweight patients.