扁桃体加腺样体切除术对阻塞性睡眠呼吸暂停低通气综合征患儿睡眠结构的影响

目的探讨扁桃体加腺样体切除术对阻塞性睡眠呼吸暂停低通气综合征（OSAHS）患儿睡眠结构的影响。方法选取45例OSAHS患儿行扁桃体加腺样体切除术,比较术前和术后3个月睡眠结构参数,包括睡眠效率（SE）、S1期比例、S2期比例、SWS期比例、REM期比例、觉醒指数（AI）、觉醒时间比例（AT%）、SaO2低于90%的持续时间占睡眠时间的百分比（SLT90%）、最低血氧饱和度（LSaO2）和氧减饱和度指数（ODI4）,并与正常儿童对照组比较,观察患儿各项指标的变化。结果 OSAHS患儿SE、SWS期、REM期和LSaO2比对照组均降低（P〈0.05）,S 1期、O D I 4和S LT 9 0%比对照组升高（P〈0.0 1）,AI和AT%比对照组升高（P〈0.05）。OSAHS患儿术后3个月SE、SWS期、REM期和LSaO2比术前均升高（P〈0.05）,S1期、AI、AT%、ODI4和SLT90%比术前降低（P〈0.05）。结论 OSAHS患儿存在睡眠结构紊乱,扁桃体加腺样体切除术能有效改善睡眠结构紊乱。

Influence of tonsillectomy and adenoidectomy on sleep structure in children with obstructive sleep apnea hypopnea syndrome

OBJECTIVE To investigate the infuence of tonsillectomy and adenoidectomy on sleep structure in children with obstructive sleep apnea hypopnea syndrome（OSAHS）.METHODS Forty five OSAHS children were selected to undergo tonsillectomy and adenoidectomy.Preoperative indexes of sleep structure were compared with those of normal children and those of post operation 3 months to study the change of sleep structure.Indexes of sleep structure were detected by polysomnography （PSG） included the sleep efficiency （SE）,stage I%,stage II%,slow wave sleep（SWS）%,rapid eye movement（REM）%,arousal index（AI）,arousal time（AT）%,percentage of time when SaO2 lower than 90% （SLT90%）,lowest SaO2 （LSaO2）,oxygen desaturation index four （ODI4）.RESULTS The preoperative SE,SWS%,REM% and LSaO2 were lower in children with OSAHS than those of normal children （P〈0.05） while the preoperative stageⅠ%,ODI4 and SLT90% were higher than normal children （P〈0.01）,and the preoperative AI and AT% were higher than normal children （P〈0.05）.The postoperative SE,SWS%,REM% and LSaO2 were higher than preoperative ones （P〈0.05）,while the postoperative stageⅠ%,AI,AT%,ODI4 and SLT90% were lower than preoperative ones （P〈0.05）.CONCLUSION There were changes of sleep structure in OSAHS children and the changes can be improved after tonsillectomy and adenoidectomy.