摘要
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)诊治的方法、效果.方法通过临床症状、鼻咽侧位X线摄片、纤维鼻咽镜检查及多道睡眠监测法(polysomnography,PSG)诊断OSAHS 70例,对睡眠呼吸暂停低通气(通气不足)指数(apnea hyponea index,AHI)≥5次/h,伴随血氧饱和度降低≥3%以上的患儿诊断为OSAHS.对其中64例腺样体和/或扁桃体肥大的患儿行手术治疗,3例伴鼻窦炎者行功能性鼻窦内窥镜术.结果有57例完成了术后随访及PSG检查,患儿临床症状明显缓解.术后1～2个月内复查PSG表明AHI、最低血氧饱和度、平均呼吸暂停时间,呼吸暂停次数等较术前有明显改善.有3例高血压患儿术后2例5～10d血压恢复正常.3例伴鼻窦炎鼻息肉者术后1～2个月复查鼻塞,头昏痛等症状明显减轻.结论儿童OSAHS有其自身特点,诊断主要依靠PSG,扁桃体和腺样体肥大是儿童OSAHS的最常见原因,腺样体和扁桃体切除手术是主要的治疗手段,并能取得良好疗效.
Objective To discuss the methods of diagnosis and treatment and effect of obstructive sleep apnea hypopnea syndrome （OSAHS） in children. Methods 70 patients were diagnosed OSAHS by clinical symptoms, X-ray for lateral Rhinopharyngeal view, nasopharyngo-fiberoscope and polysonmography （PSG）. children whose apnea hyponea index （AHI≥5/h, blood oxygen＇s saturation reducing over 3% were diagnosed as OSAHS. 64 cases with adenoidal hypertrophy or/and Tonsillar hypertrophy were treated by adenoidectomy and/or tonsillectomy, 3 cases with sinusitis-nasal polyp were treated by functional endoscopic-sinus surgery （FESS）. Results The major clinical symptoms of patients with OSAHS were obviously improved evidently after operations. In 1-2 months after surgery, PSG were checked in 57 patients again： AHI, the time of apnea, the number of times of apnea were obviously improved than preoperation. 2 of 3 cases with hypertension were improved 5-10 days after operation.clinical symptoms of 3 cases with sinusltis-nasal polyp were improved 1-2 months after operation. Conchlsion Children with OSAHS has signification themself; PSG is the major means for diagnosing. adenoidal hypertrophy or/and Tonsillar hypertrophy are main pathogenic factors in children OSAHS, adenoidectomy and/or tonsillectomy are an effective method for management of children OSAHS.
出处
《四川医学》
CAS
2005年第12期1363-1365,共3页
Sichuan Medical Journal
关键词
阻塞性睡眠呼吸暂停
儿童
腺样体
扁桃体肥大
腺样体
扁桃体手术
obstructive sleep apnea
child
adenoidal hypertrophy or/and tonsillar hypertrophy
adenoideetomy and/or tonsillectomy
