阻塞性睡眠呼吸暂停低通气综合征患儿手术前后生活质量研究  

The research of health-related quality of life in children who before and after surgery with obstructive sleep apnea hypopnea syndrome

作　　者：蔡克文[1] 叶进[1] 黎红珍[1] 徐惠清[1] 

机构地区：[1]广州市中山大学附属第三医院耳鼻咽喉-头颈外科,510630

出　　处：《中国临床实用医学》2009年第6期107-109,共3页China Clinical Practical Medicine

摘　　要：目的评价阻塞性睡眠呼吸暂停低通气综合征（obstructive sleep apnea hypopnea syndrome，OSAHS）患儿行扁桃体和（或）腺样体切除手术治疗前后生活质量的改善程度；分析多导睡眠监测（Poly-somnogram，PSG）与疾病特异性生活质量调查结果之间的相关性。方法对行整夜PSG监测确诊为OS-AHS的患儿行手术治疗，术后随访。由护理人员使用OSA-18量表对患儿手术前后生活质量进行评估，并分析术前PSG与OSA-18指标之间的相关性。结果28例PSG结果达到OSAHS诊断标准。OSAHS患儿术后的OSA-18总分及各维度评分较术前均明显降低（P〈0．01）。患儿术前呼吸暂停指数（apnea hypopnea index AHI）与OSA-18量表中睡眠障碍、身体症状和对监护人影响3个维度的评分有明显相关性（P〈0．01），而与总分及其他2个维度无显著相关（P〉0．05）。结论对PSG确诊的OSAHS患儿，扁桃体和（或）腺样体切除术后PSG指标显著改善伴随生活质量明显提高，但没有发现术前OSA-18量表评分与PSG检测指标之间有显著相关性。Objective To observe improvement in quality of life after adenotonsillectomy in children with obstructive sleep apnea hypopnea syndrome （OSAHS）. To evaluate the relationship between polysomno- gram （PSG） results and disease-specific quality of life for children with obstructive sleep apnea 18 item survey （OSA-18）. Methods 28 Children with OSAHS were enrolled. All study participants underwent overnight PSG using standardized techniques. The effectiveness of adenotonsillectomy for the relief of OSAHS was evaluated by using the OSA-18. Follow-up was assessed at 6-9 months after operation. Preoperative and postoperative OSA-18 scores for each children were compared. Results The study population inculded 28 children with OSAHS. The total OSA-18 scores and the scores for all domains showed significant improvement after surgery for children with OSAHS （P 〈 0. 001 ）. The domains of sleep disturbance, physical suffering and caregiver concerns showed signif- icant association with PSG parameters （P 〈 0. 001 ）. But no strong association was identified for OSA-18 total scores and other two domains （ P 〉 0. 05 ）. Conclusion Children with OSAHS showed a dramatic improvement in quality of life after adenotonsillectomy. Fortunately, surgical therapy with adenotonsillectomy was associated with marked improvement in quality of life for children with OSAHS. However, the association between PSG find- ings and OSA-18 scores was only moderate.

关 键 词：睡眠呼吸暂停低通气综合征 阻塞性 手术 生活质量 

分 类 号：R766[医药卫生—耳鼻咽喉科]