手术治疗腺样体肥大对儿童睡眠结构的影响

目的 观察腺样体肥大儿童在行腺样体切除术后睡眠结构的改变。方法 对120例行腺样体肥大切除术的儿童，分别于术前及术后1个月行夜间睡眠多导监测，比较手术前后宏观、微观睡眠结构的变化。结果 腺样体肥大儿童术后S1期和S2期所占比例与术前比较无统计学意义(P>0.05)；SWS期和REM期所占比例增加(P>0.05)。腺样体肥大儿童术后觉醒指数AI(2.8±0.3)较术前(6.3±0.4)明显减小(P<0.01)；术后最低SaO2（93.4±1.4）较术前(70.3±1.3) 明显提高(P<0.01)。 结论 腺样体肥大儿童术后宏观睡眠结构无明显改善，微观睡眠结构的改善可能是腺样体肥大儿童术后症状改善的病理生理学基础。

Effect of adenoidectomy on sleep architectures in children with adenoidal hypertrophy

Objective To evaluate the changes of sleep architecture in children with adenoidal hypertrophy after adenoidectomy. Methods From January 2003 to October 2006, polysomnography (PSG) was performed on 120 children with adenoidal hypertrophy before and after adenoidectomy. Various polygraphic parameters describing the macrostructure of sleep and the microstructure of sleep were analyzed . Results The S1 and S2 stages were not significantly changed after adenoidectomy(P>0.05), and the SWS and REM stages increased in ratio (P>0.05). But the arousals index before adenoidectomy was higher than that after adenoidectomy (6.3±0. 4 vs 2.8±0.3，P<0.01) and the SaO2 before operations was lower than that after operations （70.3±1.3 vs 93.4±1.4） (P<0.01). 〖WTHZ〗Conclusions There are no significant differences in the macrostructure of sleep after adenoidectomy. Improvement of the microstructure of sleep in children with adenoidal hypertrophy is the physiopathological basis of clinical relief after adenoidectomy.