手术治疗对阻塞性睡眠呼吸暂停综合征患儿睡眠结构的影响

目的观察扁桃体和(或)腺样体切除术后阻塞性睡眠呼吸暂停综合征(OSAS)儿童睡眠结构的改变，探讨OSAS儿童术后症状改善的病理生理学基础。方法对1998年12月至2003年10月广州市儿童医院收治的115例OSAS儿童进行扁桃体和(或)腺样体切除，并分别于术前及术后3个月于夜间睡眠时进行多导睡眠监测。比较手术前后宏观睡眠结构和微观睡眠结构的变化。结果手术治疗对OSAS儿童宏观睡眠结构无明显改善。微观睡眠结构：术后觉醒指数(27±02)较术前(62±04)明显减小(t=725,P<001)。结论扁桃体和(或)腺样体切除对OSAS儿童睡眠结构的改善主要体现在微观睡眠结构上，即觉醒指数明显减小。因此微观睡眠结构的改善应该是OSAS儿童术后症状改善的病理生理学基础。

Effect of adenotonsillectomy on sleep architecture in pediatric obstructive sleep apnea syndrome.

AbstractObjectiveTo evaluate change of sleep architecture in children with obstructive sleep apnea syndrome (OSAS) before and after adenoidectomy and/or tonsillectomy (A&T).MethodsFrom Dec.1998 to Oct.2003,polysomnography (PSG) was performed on 115 children with pediatric OSAS 1 or 2 days before and 3 months after A&T.Various polygraphic parameters to describe the macrostructure of sleep and the microstructure of sleep were analyzed.ResultsNo significant difference was observed in the macrostructure of sleep before and after A&T,however,OSAS had higher Arousals index(62±04) before than after A&T (27±02),t=725,P<001.ConclusionA&T can influence the microstructure of sleep.Therefore the improvement of the microstructure of sleep is the physiopathological basis of clinical relief after A&T.