婴幼儿阻塞性睡眠呼吸暂停手术治疗的临床观察  

Clinical observation of surgical treatment of obstructive sleep apnea in infants

作　　者：鲁媛媛 于振坤 LU Yuanyuan;YU Zhenkun(Department of Otolaryngology Head and Neck Surgery,Nanjing BenQ Hospital,Nanjing,Jiangsu,210019,China)

机构地区：[1]南京医科大学附属南京明基医院耳鼻咽喉头颈外科,江苏南京210019

出　　处：《中国耳鼻咽喉头颈外科》2020年第11期648-650,共3页Chinese Archives of Otolaryngology-Head and Neck Surgery

摘　　要：目的探讨应用腺样体切除和扁桃体部分切除术治疗婴幼儿阻塞性睡眠呼吸暂停(obstructive sleep apnea,OSA)的安全性及临床疗效。方法回顾性分析2016年3月~2018年8月收治的40例年龄在36个月以下的OSA患儿的临床资料。其中男31例,女9例,男女比例3.4∶1;年龄(24.9±7.3)个月,病程(9.2±6.3)个月。40例患儿因睡眠打鼾、张口呼吸、呼吸暂停、反复上呼吸道感染、喂奶困难等症状就诊。经体格检查和鼻咽侧位片检查确诊腺样体和(或)扁桃体肥大,多道睡眠图监测明确OSA诊断,监测前填写儿童生活质量调查表OSA-18问卷。40例均行手术治疗,其中腺样体切除术35例、腺样体+扁桃体部分切除术5例。术后随访6~12个月。结果40例OSA婴幼儿中以男性患儿居多,术中、术后无并发症发生。术后2~4周患儿打鼾、张口呼吸症状消失,术后6个月再次填写OSA-18问卷,手术前后问卷评分分5项维度进行比较,其差别具有统计学意义(P<0.05)。结论腺样体肥大是造成婴幼儿OSA的主要病因,应早期检查,明确诊断,积极采取手术治疗安全且有效。OBJECTIVE To explore the clinical effect of surgical treatment of obstructive sleep apnea(OSA)in infants.METHODS A retrospective analysis was made of the clinical data of 40 children with OSA aged less than 36 months from March 2016 to August 2018.Among them,there were 31 males and 9 females,the ratio of males to females was 3.4:1;the average age was(24.9±7.3)months;the average course of disease was(9.2±6.3)months.40 cases of children with sleep snoring,mouth opening breathing,apnea,repeated upper respiratory tract infections,feeding difficulties and other symptoms were consulted.Adenoid hypertrophy and/or tonsillar hypertrophy were diagnosed by physical examination and nasopharyngeal lateral film examination.OSA diagnosis was confirmed by polysomnography monitoring,and OSA-18 questionnaire was filled in before monitoring.RESULTS All 40 cases underwent surgical treatment,including adenoidectomy in 35 cases and adenoidectomy plus tonsillotomy in 5 cases.The follow-up period ranged from 6 months to 1 year.Most of the 40 OSA infants were male,and no complications occurred during and after operation.Postoperative follow-up:symptoms disappeared 2 to 4 weeks after operation,and the OSA-18 questionnaire was filled in again 6 months after operation.The scores of the questionnaire before and after operation were compared,and the difference was statistically significant(P<0.05).CONCLUSION OSA of infants is a serious disease affecting the growth and development of infants.Adenoid hypertrophy is the main cause of OSA.Early examination,definite diagnosis and surgical treatment should be the first choice.

关 键 词：婴儿 睡眠呼吸暂停 阻塞性 腺样体切除术 扁桃体周脓肿 

分 类 号：R766.9[医药卫生—耳鼻咽喉科]