儿童阻塞性睡眠呼吸暂停综合征

Clinical Analysis on Obstructive Sleep Apnea

目的 探讨儿童阻塞性睡眠呼吸暂停综合征 (OSAS)的病因诊断及治疗方法。方法 对 2 3例睡眠时有打鼾、呼吸暂停、张口呼吸等症状的儿童进行多导睡眠图 (PSG)监测 ,并行扁桃体摘除术和 (或 )腺样体刮除术 ,16例患儿术后 1个月复查PSG ,其余门诊随访。结果 2 3例患儿睡眠中均有粗响鼾声 ,鼾声指数为 2 5 0 93± 116 5 3,体块指数 (BMI)为 15 97± 3 0 1,呼吸紊乱指数 (AHI)为 9 2 3± 4 78,最低SaO2 % (87 5 2±4 95 ) % ,血氧下降≥ 3%次数 ,平均 (36 16± 10 68)次 ,SaO2 <90 %时间 (11 0 9± 3 71)min。全部经手术治疗 ,术后确诊扁桃体肿大的有 11例 ,腺样体肿大 6例 ,腺样体和扁桃体均肿大的有 6例。其中 16例患儿术后 1个月复查PSG ,治疗前后比较 ,睡眠呼吸障碍明显改善。最低SaO2 %上升、AHI下降、血氧下降≥ 3%次数、SaO2 <90 %时间及鼾声明显减少 ,以上参数治疗前后比较均P <0 0 5。结论 睡眠期有粗响鼾声、呼吸困难和与睡眠相关的呼吸暂停或低通气是小儿OSAS的特征。夜间睡眠PSG监测对于诊断是必需的 ,扁桃体切除术和 (或 )

Objective To study the pathogenesis, diagnosis method and therapeutic method for obstructive sleep apnea syndrome (OSAS) in children. Methods The polysomnography (PSG) were monitored in 23 children with snoring apnea during sleep. They had tonsillectomy and/or adenoidectomy. 16 patients were monitored by PSG one month later after operation. The other were clinical followed up. Results The loud snoring during sleep was found in all cases snoring index (250.93 16.53), body mass index (BMI) (15.97 3.01)kg/m, apnea and hypoventilation index (AHI)(9.23 4.78), the lowest SaO%(87.52 4.95)%, the times blood oxygen decreased3%(36.16 10.68), the time under SaO<90%(11.09 3.71)min. All were treated on operations. 11 cases with thehypertrophy of tonsile, 6 cases with the adenoidal hypertrophy and 6 cases with both. They were indicated obviously improved after operation. The lowest SaO% increased(P<0.05), AHI,the times blood oxygen decreased 3%, the time under SaO<90% and the loud snoring decreased obviously (P<0.05). Conclusion Loud snoring, dyspnea during sleep and sleep-related apnea and/or hypoventilation were characteristics of OSAS in the children, the PSG was necessary for the diagnosis. The tonsilectomyy and/or adenoidectomy were primary methods in treatment for children with OSAS.