阻塞性睡眠呼吸暂停低通气综合征儿童病因分析及治疗

目的：探讨阻塞性睡眠呼吸暂停低通气综合征（OSAHS）儿童的病因及治疗效果。方法：选择经多道睡眠呼吸监测（PSG）证实的3～10岁OSAHS儿童100例，经采集病史、体检后，进行咽、喉部MRI检查，进一步了解上气道病变情况；对其中80例术后随访，观察鼾症改善情况。结果：OSAHS儿童的气道阻塞原因为：腺样体肥大86例，扁桃体肥大80例，鼻窦炎38例，鼻甲肥大24例，变应性鼻炎20例，鼻中隔偏曲3例，分泌性中耳炎11例。随访扁桃体及腺样体摘除术后80例，18例失访，62例中术后鼾声完全消失52例，仍有打鼾10例。结论：OSAHS儿童主要因腺样体、扁桃体的肥大致气道阻塞，变应性鼻炎、鼻窦炎导致非阻塞性的上气道阻力增加，应积极治疗。腺样体切除有利于鼻窦炎的治疗。

Analysis of etiologic factors and treatment for children with obstructive sleep apnea hyponea syndrom

Objective:To explore the etiology and curative effect for children with obstructive sleep apnea hyponea syndrom(OSAHS).Methods:One hundred children aged from 3 to 10,diagnosed as OSAHS with the polysomnography were selected to under go the examination of pharynx,laryngeal MRI after medical history collecting and clinical examination,thus further findings of upper airway pathological changes could be obtained.62 cases were followed up after adenotonsillectomy,and improvement of snoring was observed.Results:Causes of airway obstruction of the children with OSAHS were as follows:86 cases adenoidal hypertrophy,80 cases hypertrophy of tonsils,38 cases nasosinusitis,24 cases hypertrophy of nasal turbinate,20 cases allergic rhinitis,and 3 cases deflection of septum.After adenotonsillectomy,80 cases were followed up,18 cases failed to follow up.Among 62 remaining cases,10 cases still had snoring,while 52 cases completely disappeared.Conclusion:Adenotonsillar hypertrophy mainly leads to increasing obstructive upper airway resis-tance in children OSAHS,and children with OSAHS need active treatment.Children with nasosinusitis are prone to be treated after adenotonsillectomy.