Li Hsueh-Yu, Huang Yu-Shu, Chen Ning-Hung, Fang Tuan-Jen, Lee Li-Ang
Department of Otolaryngology, Chang Gung Memorial Hospital, and Department of Nursing, Chang Gung Institute of Technology, Taoyuan, Taipei, Taiwan.
Laryngoscope. 2006 Jul;116(7):1142-7. doi: 10.1097/01.mlg.0000217542.84013.b5.
OBJECTIVES/HYPOTHESIS: Children with sleep-disordered breathing may experience behavioral and learning problems such as inattentiveness and hyperactivity. The aim of this study was to measure the impact of adenotonsillectomy on sleep-related adverse events and behavioral problems in children with sleep-disordered breathing.
This prospective and interventional study enrolled 40 sleep-disordered breathing children (mean age, 8.4+/-1.6 years) with hypertrophic tonsils and adenoids. All patients completed two polysomnographies, tests of variables of attention (TOVAs), and Child Behavior Checklists, one at baseline and the other 6 months after adenotonsillectomy.
The apnea-hypopnea index (P<.001), TOVA scores (P<.001), and 8 of 9 individual domains of the Child Behavior Checklist scores (P<.05) significantly improved after surgery. However, the change in the apnea-hypopnea index was not negatively correlated with TOVA score (r=-0.17, P=.38).
Adenotonsillectomy could significantly improve behavior (TOVA) scores, but the improvement may not simply be attributable to changes in sleep apnea events.
目的/假设:患有睡眠呼吸障碍的儿童可能会出现行为和学习问题,如注意力不集中和多动。本研究的目的是评估腺样体扁桃体切除术对患有睡眠呼吸障碍儿童的睡眠相关不良事件和行为问题的影响。
这项前瞻性干预研究纳入了40名患有扁桃体和腺样体肥大的睡眠呼吸障碍儿童(平均年龄8.4±1.6岁)。所有患者均完成了两次多导睡眠图检查、注意力变量测试(TOVA)和儿童行为检查表,一次在基线时进行,另一次在腺样体扁桃体切除术后6个月进行。
术后呼吸暂停低通气指数(P<0.001)、TOVA评分(P<0.001)以及儿童行为检查表评分9个单项领域中的8个(P<0.05)均有显著改善。然而,呼吸暂停低通气指数的变化与TOVA评分无负相关(r=-0.17,P=0.38)。
腺样体扁桃体切除术可显著改善行为(TOVA)评分,但这种改善可能不仅仅归因于睡眠呼吸暂停事件的变化。