阻塞性睡眠呼吸暂停低通气综合征患儿扁桃体腺样体切除术临床疗效分析

Therapeutic effects of adenoidectomy and tonsillectomy in children with obstructive sleep apnea hypopnea syndrome

目的评价扁桃体腺样体切除术对阻塞性睡眠呼吸暂停低通气综合征(OSAHS)患儿的临床疗效。方法行扁桃体及腺样体切除术患儿80例,术前、术后3个月或6个月行多道睡眠描记术(PSG)监测及OSA-18量表生活质量调查,分析手术疗效、PSG参数及OSA-18评分的变化。结果 80例患儿治愈70例(87%),显效8例(10%),有效2例(3%),总有效率为100%。显效及有效的10例中8例合并变应性鼻炎经治疗变应性鼻炎后症状明显改善,另2例肥胖者经控制体质量后症状减轻。术后呼吸暂停低通气指数(AHI)、最低血氧饱和度(LSaO2)、OSA-18总分与术前比较差异有统计学意义(P<0.05)。结论扁桃体、腺样体切除术是治疗儿童OSAHS的有效方法,同时应治疗合并的其他上呼吸道阻塞因素。PSG结合OSA-18调查表可对患儿进行手术前后主客观的综合评价。

Objective To investigate the clinical effectiveness of adenoidectomy and tonsillectomy in children with obstructive sleep apnea hypopnea syndrome（OSAHS）. Methods Clinical data of eighty children undergoing adenoid- ectomy and tonsillectomy were reviewed, including polysomnography（PSG） and OSA-18 scale three months preopera- tive and six months post-operative. Effects of operation, changes of PSG parameters and OSA-18 scores were analyzed. Results Among eighty cases, there were seventy cured（ 87 % ）, 8 markedly effective（ 10% ）, and 2 improved（3 % ）. The total effective rate was 100%. In the latter ten cases, symptoms of allergic rhinitis were significantly improved in eight cases, and obesity-associated symptoms were relieved in the other two cases. The clinical parameters, such as ap- nea hypopnea index（ AHI）, lowest oxygen saturation （ LsaOz ） and OSA-18 score, were significantly improved after the operation （P 〈 0.05）. Conclusion Tonsillectomy and （or） adenoidectomy are effective procedures to treat OSAHS in children. PSG and OSA-18 scale are comprehensive tools to evaluate the clinical results.