儿童阻塞性睡眠呼吸暂停低通气综合征的临床分析

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）的临床特点及手术治疗效果。方法 对我科65例OSAHS的患儿进行鼻咽CT、鼻内镜或纤维鼻咽喉镜及多导睡眠监测，有耳部症状的患儿行纯音听阚测定和／或声导抗检查。对扁桃体和／或腺样体肥大的患儿行手术治疗，如有鼓室积液者行鼓膜切开置管术。结果 OSAHS患儿多有入睡打鼾，夜晚睡眠不安、张口呼吸、听力下降等症状，存在扁桃体和／或腺样体肥大引起上气道阻塞。65例全部行手术治疗，单纯扁桃体切除5例，单纯腺样体刮除2例，扁桃体加腺样体切除（tonsillectomy and adenoidectomy T＆A）53例，2例腺样体切除加鼓膜置管，3例扁桃体切除、腺样体切除、鼓膜切开加置管术。62例（占95．4％）患儿行扁桃体加／或腺样体切除术后症状明显改善。结论 儿童OSAHS有自身的特点，儿童的OSAHS大多因扁桃体肥大及腺样体肥大引起，扁桃体加腺样体切除术（tonsillectomy and adenoidectomy T＆A）在治疗儿童OSAHS上有显著的效果。

Clinical Analysis of Obstructive Sleep Apnea Hypopnea Syndrome in Children

Objective:To discuss the clinical characteristic and operative treatment effect of obstructive sleep apnea hypopnea syndrome(OSAHS)in children.Methods 65 cases OSAHS children have received nasopharynx CT,nose endoscopy or fibre nasopharynx laryngoscope examination and polysomnography(PSG)monitoring,pure tone audiometry and/or aural acoustic immittance examination was performed in pediatric patients who have auditive symptom.Operative treatment was performed for patients with tonsil hypertrophy and adenoids,and myringotomy with grommet insertion were performed for those with tympanic cavity empyema.Results The major symptoms of patients with OSAHS are snoring in sleep,discomfortable sleep at night,breathing open mouth and hearing loss,obstruction of upper air-passage due to tonsil hypertrophy and/or adenoids also exist.65 cases all undergone operative treatment,only tonsillectomy in 5,only adenoidectomy in 2,tonsillectomy and adenoidectomy in 53,tonsillectomy and myringotomy with grommet insertion in 2,tonsillectomy and adenoidectomy and tonsillectomy and adenoidectomy in 3.among which,symptom of 62 pediatric patients(account for 95.4%)had been evidently relieved after tonsillectomy and/or adenoidectomy(T & A).Conclusions Children with OSAHS has its own character,OSAHS of children mostly is caused by tonsil hypertrophy and/or adenoids,so tonsillectomy and adenoidectomy(T & A)has remarkable effect on the curing of OSAHS pediatric patients.