儿童鼾症术后复发再次治疗方案的探讨

Exploration of the retreatment protocol for postoperative recurrence of pediatric obstructive sleep apneahypopnea syndrome

目的探讨术后复发的儿童鼾症的治疗方案。方法选取2016年1月至2019年12月于本院就诊的鼾症术后复发并再次进行治疗患儿56例,针对复发病因采取药物治疗或手术治疗,6个月后复查患儿的每小时睡眠呼吸暂停低通气的指数(AHI)及最低血氧饱和度,并填写儿童OSAHS生活质量调查表(OSA-18)。结果 56例患儿经过再次治疗,治愈40例(71.43%),显效16例(28.57%)。治疗后,AHI为(3.37±1.93)次/h,明显低于治疗前的(17.83±7.29)次/h,差异具有统计学意义(t=14.34,P=0.000)。治疗后,最低血氧饱和度为(96.5±3.2)%,明显高于治疗前的(83.8±6.2)%,差异具有统计学意义(t=-13.62,P=0.000)。治疗后,OSA-18量表总体评分为(31.8±5.7)分,明显低于治疗前的(88.1±9.7)分(P<0.01)。结论针对复发的儿童鼾症患儿,通过分析其复发的病因,采取包括再次手术和规范药物治疗的综合治疗可取得良好的治疗效果。

Objective To investigate the treatment of postoperative recurrent snoring in children.Methods From January 2016 and December 2019 in our hospital clinic of postoperative recurrence and again sleep apnea treated with 56 cases,the causes to take medication or surgical treatment for recurrent,six months after the review of the patient's per hour of sleep apnea hypoventilation index(AHI)and the lowest oxygen saturation,and fill the children OSAHS quality of life questionnaire(OSA-18).Results After retreatment,40 cases(71.43%)were cured and 16 cases(28.57%)showed remarkable effect.After treatment,AHI was(3.37±1.93)times/h,which was significantly lower than(17.83±7.29)times/h before treatment,the difference was statistically significant(t=14.34,P=0.000).After treatment,the minimum blood oxygen saturation was(96.5±3.2)%,significantly higher than that before treatment(83.8±6.2)%,the difference was statistically significant(t=-13.62,P=0.000).After treatment,the overall score of OSA-18 scale was(31.8±5.7)scores,which was significantly lower than that of(88.1±9.7)scores before treatment(P<0.01).Conclusion For children with recurrent snoring,comprehensive treatment including reoperation and standard drug therapy can achieve good therapeutic effect by analyzing the cause of recurrence.