儿童阻塞性睡眠呼吸暂停综合征临床观察

目的探讨阻塞性睡眠呼吸暂停低通气综合征(obstructive sleep apnea hypopnea syndrome,OSAHS)的诊断及治疗方法。方法对23例睡眠时有打鼾、呼吸暂停、张口呼吸等症状的儿童进行多导睡眠图(polysomnography,PSG)监测,符合OSAHS 诊断标准,并行扁桃体摘除术和(或)腺样体刮除术,患儿术后1个月复查 PSG。结果扁桃体肥大的有5例,腺样体肥大10例,腺样体和扁桃体均肥大的有8例。患儿术后1个月复查 PSG,治疗前后比较,睡眠呼吸障碍症状明显改善。最低SaO_2%上升、AHI 下降、最长呼吸暂停时间明显缩短,以上参数治疗前后比较均 P<0.01。结论夜间睡眠 PSG 监测对于诊断是必要的,扁桃体切除术和(或)腺样体刮除术是治疗小儿 OSAHS 的主要方法。

Clinical Observation on 23 Cases Obstructive Sleep Apnea Hypopnea Syndrome of Children

Objective To study the pathogenesis,diagnosis method and therapeutic method for obstructive sleep apnea hypopnea syndrome (OSAHS)in children.Methods The polysomnography(PSG)were monitored in 23 children with snoring or apnea during sleep.They had ton- sillectomy and/or adenoidectomy.All patients were monitored by PSG one month later after operation.The other were clinical followed up.Results All were treated on operations.5 cases with the hypertrophy of tonsile,10 cases with the adenoidal hypertrophy and 8 cases with both.They were indicated obviously improved after operation.The lowest SaO2% increased(P<0.01),AHI and the longest apnea time decreased obviously (P<0.01).Conclusion Loud snoring during sleep and sleep-related apnea and/or hypopnea were characteristics of OSAHS in the children, the PSG was necessary for the diagnosis.The tonsilectomyy and/or adenoidectomy were primary methods in treatment for children with OSAHS.