睡眠呼吸障碍儿童疾病特异性生存质量评价  

Evaluation for disease-specific quality of life in children with sleep.disordered breathing

作　　者：何培杰[1] 鲍欢[2] 肖宽林[1] 

机构地区：[1]复旦大学附属眼耳鼻喉科医院耳鼻咽喉头颈外科,上海200031 [2]上海同济大学附属东方医院神经内科

出　　处：《中华全科医师杂志》2008年第3期161-163,共3页Chinese Journal of General Practitioners

摘　　要：目的评价睡眠呼吸障碍（sleep—disordered breathing）对儿童生存质量的影响，探讨扁桃体和腺样体切除术在改善睡眠呼吸障碍儿童生存质量中的作用。方法采用儿童阻塞性睡眠呼吸暂停疾病特异性生存质量调查表（OSA-18）评价168例睡眠呼吸障碍儿童扁桃体和腺样体切除术前后的生存质量，对62例同时进行多导睡眠监测者，分析呼吸暂停低通气指数、最低血氧饱和度与OSA-18评分的相关性。将50例无打鼾的健康儿童作为对照。结果手术组术前OSA-18评分（734-15）高于对照组（28±8），差异有统计学意义（t=15．12，P〈0．01）；睡眠呼吸障碍对30．4％（51／168）患儿生存质量造成严重影响；手术前OSA-18评分与呼吸暂停低通气指数、最低血氧饱和度存在相关性；扁桃体和腺样体切除术后约73．8％（124／168）的患儿生存质量得到明显改善。结论睡眠呼吸障碍对儿童生存质量造成影响，扁桃体和腺样体切除术能够改善其生存质量；OSA-18评分与多导睡眠监测的客观指标之间存在相关性；OSA-18有助于儿童睡眠呼吸障碍的诊断并可对干预措施疗效进行量化评价。Objective To evaluate the impact of sleep-disordered breathing （SDB） on the quality of life （QOL） in children with SDB and investigate the value of tonsillectomy and adenoidectomy in improving their QOL. Methods Questionnaire of disease-specific quality of life for children with obstructive sleep apnea with 18 items （OSA-18） was used to evaluate QOL in 168 children with SDB within four weeks before and six to 12 months after surgical operation, and correlation between OSA-18 scores to apnea hypopnea index （AHI） and minimum oxygen saturation （MiO2 ） in 62 of them was evaluated with polysomnography （PSG）, with 50 healthy children without snoring as controls. Results Overall scores of OSA-18 in children of SDB group before surgical operation were significantly higher than those in children of control group （t = 15.12, P 〈 0. 01 ）. and QOL was seriously affected in 30.4 percent of the children with SDB. Scores of OSA-18 correlated to AHI and MiO2 before surgical operation. QOL was improved significantly in 73.8 percent of children with SDB after tonsillectomy and adenoidectomy. Conclusions SDB has obvious impact on pediatric QOL, which can be improved by tonsillectomy and adenoidectomy. There exists significant correlation between OSA-18 scores and objective indicators of PSG, and the former can be used as clinical diagnosis for SDB in children and as quantitative evaluation for the effectiveness of intervention.

关 键 词：睡眠障碍 生活质量 扁桃体切除术 增殖腺切除术 

分 类 号：R766[医药卫生—耳鼻咽喉科]