肥胖对儿童OSAHS手术疗效的影响

Impact of obesity on treatment outcomes in paediatric obstructive sleep apnea-hypopnea syndrome

目的：研究肥胖对儿童OSAHS手术疗效的影响。方法：对89例肥胖0SAHS思儿（肥胖组）和105例正常体重OSAHS患儿（正常组）行腺样体扁桃体切除术，通过多导睡眠监测（PSG）比较患儿手术前后睡眠结构的变化。结果：肥胖组和正常组的呼吸暂停低通气指数、最低血氧饱和度、觉醒指数及快动眼睡眠百分率手术前后比较均差异有统计学意义（均P〈0．05）。与正常组比较，肥胖组术后存在OSAHS的危险性较高，OR为6．3，95％CI为1．8～12．9。对术前AHI进行校准后，肥胖仍然是术后存在OSAHS的显著危险因素，OR为3．8，95％CI为1．5～11．2。结论：肥胖组及正常组患儿术后的睡眠呼吸参数明显改善，但大多数肥胖患儿术后仍持续存在0SAHS。

Objective： To investigate the impact of obesity on treatment outcomes in paediatric obstructive sleep apnea-hypopnea syndrome（OSAHS）. Method： Adenotonsillectomy were performed in 89 obese children and 105 normal-weight children with OSAHS. Polysomnography（PSG） was conducted before and after surgery in all cases to analyze the changes of sleep-breathing parameters. Result： Preoperatively, the median obstructive apnea- hypopnea index（AHI） was 24.6 for the obese and 17.3 for the control（P〈0.05）. Postoperatively, the AHI was 11.3 for the obese and 4.8 for the control （P〈0.05）. The odds ratio（OR） for persistent （3SAHS in obese com- pared to non-obese children was 6.3（95%CI 1.8-12.9）. Using initial AHI as a calibration, these data showed that obesity in children had an adjusted OR（3.8） for persistent OSAHS after adenotonsillectomy, （95 % CI 1.5-11.2）. Conclusion： Adenotonsillectomy can significantly improve the sleep-breathing parameters in all children with OSAHS,but persistent OSAHS are more common in obese children than that in the normal-weight children after surgeries.