儿童OSAHS伴心律失常患者行腺样体切除+扁桃体切除后心率、心律变化  

Analysis of Characteristics of Heart Rate and Heart Rhythm in Children with Obstructive Sleep Apnea-hypopnea Syndrome after Tonsillectomy and Adenoidectomy

作　　者：邹月娥[1] 王富森[1] 

机构地区：[1]广东省佛山市第二人民医院心电图室,广东佛山510630

出　　处：《临床医学工程》2011年第11期1712-1714,共3页Clinical Medicine & Engineering

基　　金：广东省佛山市医学类科技攻关项目(编号:200708017)

摘　　要：目的探讨儿童OSAHS伴心率失常患者行腺样体切除+扁桃体切除后心率变化。方法对2003年3月至2009年4月间63例轻中度OSAHS伴心率失常患者行腺样体切除+一侧扁桃体切除后,对比观察治疗前及治疗后3、6月PSG(AHI、SaO2)、24h动态心电图的变化。结果轻度患儿OSAHS治愈率达100%,中度患儿OSAHS治愈率达96%,差异有统计学意义(P<0.01);治疗前后在清醒状态,治疗前后的最快、最慢及平均心率比较,差异无统计学意义(P>0.01);在睡眠状态,治疗前后的最快、最慢心率比较,治疗后的最快心率及平均心率慢于治疗前,最慢心率快于治疗前,差异有统计学意义(P<0.01);两者缓慢性心律失常的发生率相比,差异无统计学意义;两者快速性心律失常的发生率相比,差异有统计学意义(P<0.01),治疗后的快速性心率失常的发生率明显降低。腺样体切除+一侧扁桃体切除可明显改善OSAHS患儿呼吸睡眠参数(AHI、mSaO2),能有效降低快速心律失常发生率,且差异有统计学意义(P<0.01)。结论 OSAHS可能为儿童心率、心律失常的原因之一;腺样体切除+一侧扁桃体切除为儿童OSAHS伴心律失常的有效治疗方法之一。Objective To analyze the characteristics of heart rate and heart rhythm in children with obstructive sleep apnea-hypopnea syndrome after tonsillectomy and adenoidectomy. Methods 63 patients underwent PSG before and after tonsillectomy and adenoidectomy. Before and after the operation, the data including AHI, SaO2 and ambulatory electrocardiogram was analyzed. Results There was no staistically significant changes of bradycardia and heart rate during wake between the two groups. There was staistically significant improvement in PSG （AHI, SaO2） and much more lower incidence of trachycardia in postperative group; the maximum HR and measn HR were staistically significantly lower during sleep in postperative group, and the minimum HR was significantly higher during sleep in postperative group. Conclusion As OSAHS in children, operation of tonsillectomy and adenoidectomy may inflence the incidence of trachycardia and HR, and the operation is one of the effective thrarapies.

关 键 词：儿童 睡眠呼吸暂停低通气综合征 动态心电图 

分 类 号：R541.7[医药卫生—心血管疾病]