OSA-18调查表法对儿童阻塞性睡眠呼吸障碍患者生活质量评估的临床意义

Clinical significance of OSA-18 questionnaire to assessing quality of life in children with obstructive sleep-disordered breathing

目的利用儿童阻塞性睡眠呼吸暂停疾病特异性生活质量调查表（disease-specific quality of life for chidren with obstructive sleep apnea 1 8 items survey,OSA-1 8）,对手术治疗前后儿童阻塞性睡眠呼吸障碍（obstructive sleep disordered breathing,OSDB）患者的生活质量进行评估,探讨OSA-18的临床应用意义。方法对30例因扁桃体和（或）腺样体肥大的OSDB患者,采用OSA-18法在术前和术后6个月进行调查,评价手术治疗对OSDB患者生活质量的影响,并对评估结果以及相关问题进行讨论。结果OSDB患儿术后生活质量总分及各维度总评分较术前明显下降（P均〈0.0 1）,改善明显。其中睡眠障碍、身体症状、病情对患儿监护人的影响3个维度的变化值〉1.50,达到显著改善;情绪不佳、白天功能两个维度的变化值在0.50~0.99,为轻度改善。在所有的18个条目中,手术前后平均积分的比较,其差别均具有统计学意义（P〈0.05）。结论OSA-18调查表法可以全面反映儿童OSDB患者的生活质量,OSA-18调查在儿童OSDB的临床诊断、治疗选择和疗效评估均有较好的实用价值,是儿童OSDB疗效评价的可靠方法。

Objective To investigate clinical application and significance of OSA-18 questionnaire on evaluating quality of life （ QOL ） in children with obstructive sleep- disordered breathing （ OSDB ） via comparing QOL before and after surgery with OSA-18 questionnaire. Methods 30 children diagnosed as OSDB due to enlarged tonsils and/or adenoidal hypertrophy were enrolled. OSA-18 questionnaire was used for assessing the effect of surgical treatment on their QOL via comparison of QOL before and 6 moths after surgery. Results The total OSA-18 scores and the scores of each dimension for OSDB children decreased significantly after surgery （ P 〈 O. 01 ）. Variations were greater than 1.50 on dimensions of sleep disturbance, physical symptoms and disease impact on children＇ s guardians, which meant significant improvement. Changed values were between O. 50 and O. 99 on dimensions of bad emotional and daytime functions, which improved slightly. In all the 18 entries, comparison of average scores before and after surgery showed statistically significant differences （ all P 〈 0.05 ）. Conclusions The OSA- 18 questionnaire can fully reflect the QOL in children with OSDB. It has good practical value on clinical diagnosis, treatment choice and efficacy evaluation for children with OSDB.