儿童阻塞性睡眠呼吸暂停低通气综合征诊断和治疗  

Diagnosis and treatment of obstructive sleep apnea hypopnea syndrome in children

作　　者：熊志洁[1] 章松勤[1] 何文霞[1] 陈云蒙[1] 

机构地区：[1]湖北省宜昌市第一人民医院耳鼻咽喉科,湖北宜昌443000

出　　处：《中国耳鼻咽喉头颈外科》2005年第9期591-593,共3页Chinese Archives of Otolaryngology-Head and Neck Surgery

摘　　要：目的探讨儿童阻塞性睡眠呼吸暂停低通气综合征(obstructive sleep apnea hypopnea syndrome,OSAHS)患儿的诊断标准、治疗方法及疗效观察。方法78例经多导睡眠仪监测(polysomnography,PSG)确诊的OSAHS儿童采取扁桃体和(或)腺样体切除术68例,鼻内镜下双下甲减容手术14例,上颌窦自然开口扩大术6例;选择长期正压通气治疗(continuous positive airway pressure,CPAP)2例。采用儿童OSAHS生活质量调查表(OSA-18)对78例进行治疗前后随访。结果围手术期无术后出血和急性呼吸道梗阻发生。随访18个月以上,OSA-18调查评分显示:显效69例(88.5%),有效8例(10.2%),无效1例(1.3%)。结论儿童OSAHS在诊断上一定要详细进行询问及查体,并根据PSG结果确诊。治疗主要采用手术治疗,经2.4mm鼻内镜引导下行腺样体刮除术,CPAP治疗对于不适合手术者有效。OBJECTIVE To evaluate the diagnosis, treatment and curative effect of obstructive sleep apnea hypopnea syndrome（OSAHS）in children. METHODS There were 78 children with OSAHS diagnosed by polysomnography（PSG）in this study. Among them,68 cases underwent tonsillectomy and/or adenoidectomy, 14 cases underwent inferior turbinate coblation or endoscopic sinus surgery. Continuous positive airway pressure（CPAP）was used in 2 cases. OSA-18（quality of life for children with obstructive sleep apnea 18 items）was adopted to evaluate the quality of life of children before and after treatment. RESULTS No postoperative bleeding or acute upper airway obstruction occurred during perioperative period. OSA-18 scores showed that quality of life was significantly improved in 69 cases（88.5%）,improved in 8 cases （10.2%）,no effect in 1 cases （1.3%） after following up for over 18 months. CONCLUSION The tonsillectomy and adenoidectomy are the main method for management of OSAHS children.

关 键 词：儿童 睡眠呼吸暂停 阻塞性 内窥镜检查 多导睡眠描记术 阻塞性睡眠呼吸暂停低通气综合征 综合征诊断 治疗方法 syndrome OSAHS 

分 类 号：R766[医药卫生—耳鼻咽喉科]