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儿童阻塞性睡眠呼吸暂停行腺样体扁桃体切除术后的生活质量

Quality of life after adenotonsillectomy for obstructive sleep apnea in children.

作者信息

Mitchell Ron B, Kelly James, Call Ellen, Yao Naomi

机构信息

Department of Pediatrics, University of New Mexico, Health Sciences Center, Albuquerque 87131, USA.

出版信息

Arch Otolaryngol Head Neck Surg. 2004 Feb;130(2):190-4. doi: 10.1001/archotol.130.2.190.

Abstract

OBJECTIVE

To study changes in quality of life in children after adenotonsillectomy for obstructive sleep apnea (OSA) documented by full-night polysomnography.

DESIGN AND SETTING

Prospective study of children with OSA at the University of New Mexico Children's Hospital, Albuquerque.

METHODS

Caregivers for children were asked to complete the OSA-18 quality of life survey prior to polysomnography. Children who met inclusion criteria and had a respiratory distress index higher than 1 were enrolled in the study and underwent adenotonsillectomy. Caregivers completed a second OSA-18 survey within 6 months of surgery. Scores from the preoperative and postoperative surveys were compared using the paired t test.

RESULTS

The study population included 60 children (mean age, 7.1 [range, 3-12] years), of whom 43 (72%) were male and 30 (50%) were younger than 6 years. Forty-seven children (78%) had a respiratory distress index of 10 or higher. The mean interval between the 2 surveys was 126 days. The mean total OSA-18 score was 71.4 before surgery and 35.8 after surgery. The domain with the greatest change in mean score was sleep disturbance, which improved by 11.5. The changes in total score, in the scores for each domain, and for each item of the OSA-18 survey were highly significant (P<.002).

CONCLUSIONS

Children without significant comorbidities show a marked improvement in the domains of sleep disturbance, physical symptoms, emotional symptoms, and daytime functioning as reported by their caregivers after adenotonsillectomy for OSA.

摘要

目的

通过全夜多导睡眠图记录,研究阻塞性睡眠呼吸暂停(OSA)患儿行腺样体扁桃体切除术后生活质量的变化。

设计与地点

在新墨西哥大学儿童医院(阿尔伯克基)对OSA患儿进行的前瞻性研究。

方法

要求OSA患儿的照料者在多导睡眠图检查前完成OSA-18生活质量调查问卷。符合纳入标准且呼吸窘迫指数高于1的患儿纳入研究并接受腺样体扁桃体切除术。照料者在术后6个月内完成第二次OSA-18调查问卷。使用配对t检验比较术前和术后调查问卷的得分。

结果

研究人群包括60名儿童(平均年龄7.1岁[范围3-12岁]),其中43名(72%)为男性,30名(50%)年龄小于6岁。47名儿童(78%)的呼吸窘迫指数为10或更高。两次调查的平均间隔时间为126天。术前OSA-18总平均得分为71.4分,术后为35.8分。平均得分变化最大的领域是睡眠障碍方面,改善了11.5分。OSA-18调查问卷的总分、各领域得分及各项目得分的变化均具有高度统计学意义(P<0.002)。

结论

对于无显著合并症的儿童,在因OSA行腺样体扁桃体切除术后,照料者报告其在睡眠障碍、身体症状、情绪症状和日间功能等领域有显著改善。

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