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腭裂患儿在接受Furlow腭成形术或咽瓣修复腭咽闭合不全后阻塞性睡眠呼吸暂停综合征的比较。

Comparison of obstructive sleep apnea syndrome in children with cleft palate following Furlow palatoplasty or pharyngeal flap for velopharyngeal insufficiency.

作者信息

Liao Yu-Fang, Noordhoff M Samuel, Huang Chiung-Shing, Chen Philip K T, Chen Ning-Hung, Yun Claudia, Chuang Ming-Lung

机构信息

Division of Orthodontics, the Craniofacial Center, Chang Gung Memorial Hospital, Taipei, Taiwan.

出版信息

Cleft Palate Craniofac J. 2004 Mar;41(2):152-6. doi: 10.1597/02-162.

Abstract

OBJECTIVE

To evaluate the incidence and severity of obstructive sleep apnea syndrome (OSAS) in patients with cleft palate having a Furlow palatoplasty or pharyngeal flap for correction of velopharyngeal insufficiency (VPI).

PATIENTS

A total of 48 nonsyndromic children with repaired cleft palate with VPI were enrolled in the study. Twenty of the children had a Furlow palatoplasty (F group) and 28 children had a pharyngeal flap (P group) for correction of VPI.

INTERVENTIONS

An overnight polysomnography evaluation was done to evaluate the incidence and severity of OSAS 6 months or more postoperatively.

MAIN OUTCOME MEASURES

Symptoms of OSAS, respiratory disturbance index (RDI), oxyhemoglobin desaturation index (DI), and sleep stages were measured.

RESULTS

In the P group, the mean percentage of stage 2 sleep was lower than the F group (p <.05). The mean RDI and DI were larger in the P group, compared with the F group (p <.001). The incidence and severity of OSAS were higher in the P group, compared with the F group (p <.001 and p = 0.05, respectively).

CONCLUSIONS

A Furlow palatoplasty should be used in deference to a pharyngeal flap whenever possible on the basis of the preoperative evaluation of VPI because of the decreased incidence and severity of OSAS.

摘要

目的

评估采用Furlow腭成形术或咽瓣修复腭裂患者腭咽闭合不全(VPI)后阻塞性睡眠呼吸暂停综合征(OSAS)的发生率和严重程度。

患者

本研究共纳入48例非综合征性腭裂修复术后合并VPI的儿童。其中20例儿童接受Furlow腭成形术(F组),28例儿童接受咽瓣修复术(P组)以纠正VPI。

干预措施

术后6个月或更长时间进行整夜多导睡眠图评估,以评估OSAS的发生率和严重程度。

主要观察指标

测量OSAS症状、呼吸紊乱指数(RDI)、氧合血红蛋白去饱和指数(DI)和睡眠阶段。

结果

P组2期睡眠的平均百分比低于F组(p<.05)。与F组相比,P组的平均RDI和DI更大(p<.001)。与F组相比,P组OSAS的发生率和严重程度更高(分别为p<.001和p = 0.05)。

结论

基于术前对VPI的评估,由于OSAS的发生率和严重程度降低,应尽可能优先于咽瓣使用Furlow腭成形术。

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