儿童阻塞性睡眠呼吸暂停低通气综合征合并变应性鼻炎的临床分析  

Clinical Analysis of Obstructive Sleep Apnea-Hypopnea Syndrome in Children Complicated with Allergic Rhinitis

作　　者：包亚军[1] 周雯娟[1] 武颖异[1] 耿丽丽[1] 

机构地区：[1]解放军第359医院耳鼻咽喉科,镇江212001

出　　处：《成都医学院学报》2013年第2期192-194,共3页Journal of Chengdu Medical College

基　　金：中国高校医学期刊临床专项资金(NO:11321013)

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)与儿童变应性鼻炎(allergic rhinitis,AR)的关系以及治疗方法和手术适应证。方法通过病史采集、体征检查、变应原检测、血清IgE检测、鼻内镜检查、多导睡眠监测(PSG)等方法对明确诊断的116例儿童OSAHS合并AR患者的临床资料进行回顾性分析。对接受正规药物治疗4w以上仍有睡眠呼吸暂停或低通气现象,AHI≥5次/h,LSaO2<92%的患儿,行腺样体切除和/或扁桃体切除术,治疗前后随访进行统计学研究。结果药物治疗后AR症状明显缓解,药物治疗OSAHS合并AR的治愈率为40.5%,其余进一步行腺样体和/或扁桃体切除术,手术后总治愈率为95.7%。结论儿童OSAHS与AR之间关系密切,手术治疗前后必须接受正规系统药物治疗,若治疗后仍有呼吸暂停或低通气现象,AHI≥5次/h,LSaO2<92%的患儿才具有手术治疗的适应证。Objective To investigate the relationship between obstructive sleep apnea-hypopnea syndrome （OSAHS）and allergic rhinitis （AR）in children, the therapeutic method and indication of surgery. Methods 116 children diagnosed principally on the basis of polysomnography, history taking, clinical signs, nasal endoscopy, detection of allergens and IgE as having OSAHS and AR were retrospective analyzed. After 4 weeks of regular drug therapy（nasal glucocorticoid inhalation）, or Adenotonsillectomy/ tonsillotomy if apnea/hypopnea idex （AHI） 5 times/h,Lowest SaO2 （LSaO2）〈92% ,all data were compared between pre-treatment and post-treatment. Results Drug therapy can ameliorate significantly clinical condition,recovery rate of drug therapy was 40.5% comparison with 95.7 % of recovery rate using surgery in OSAHS complicated AR. Conclusion OSAHS was closely correlated with AR. Regular drug therapy should be enforced before surgery because it can avoid unnecessary surgery. Only AHI ~Stimes/h and LSaO2〈92 % were an indication of surgery.

关 键 词：儿童 变应性鼻炎 阻塞性睡眠呼吸暂停低通气综合征 

分 类 号：R765.21[医药卫生—耳鼻咽喉科] R766.4[医药卫生—临床医学]