Constantin Evelyn, Kermack Andrea, Nixon Gillian M, Tidmarsh Lee, Ducharme Francine M, Brouillette Robert T
Department of Pediatrics, Montreal Children's Hospital, McGill University, Montreal, Canada.
J Pediatr. 2007 May;150(5):540-6, 546.e1. doi: 10.1016/j.jpeds.2007.01.026.
To obtain parental perspectives on changes in sleep, breathing, quality of life (QOL), and neurobehavioral measures after adenotonsillectomy.
This retrospective cohort study comprised otherwise healthy children evaluated for obstructive sleep apnea syndrome (OSAS) from 1993 to 2001. We compared those children who underwent adenotonsillectomy with those children who did not. The parents of 473 children (292 boys) 2 years of age and older were sent questionnaires to evaluate QOL and clinical and behavioral changes. For 94 children 3 years of age and older, behavioral changes were evaluated using the Conners' Parent Rating Scale-Revised (CPRS-R) for three different periods: pre-operatively/pre-polysomnography, postoperatively/postpolysomnography, and recently.
One hundred and sixty-six questionnaires were returned (35%), 138 of which were complete with written consent provided. Compared with parents of unoperated children, parents of children who had adenotonsillectomy were more likely to report improvements in sleep, breathing, and QOL but not improvements in concentration, school performance, and intellectual or developmental progress. Both short and long term, there were no significant effects of adenotonsillectomy on any of the CPRS-R behavior subscales.
From a parental perspective, adenotonsillectomy frequently improves sleep, breathing, and QOL but does not often improve neurobehavioral outcomes.
获取家长对于腺样体扁桃体切除术后睡眠、呼吸、生活质量(QOL)及神经行为指标变化的看法。
这项回顾性队列研究纳入了1993年至2001年间因阻塞性睡眠呼吸暂停综合征(OSAS)接受评估的健康儿童。我们将接受腺样体扁桃体切除术的儿童与未接受该手术的儿童进行了比较。向473名2岁及以上儿童(292名男孩)的家长发放问卷,以评估生活质量以及临床和行为变化。对于94名3岁及以上儿童,在三个不同时期使用康纳斯父母评定量表修订版(CPRS-R)评估行为变化:术前/多导睡眠图检查前、术后/多导睡眠图检查后以及近期。
共收回166份问卷(35%),其中138份在获得书面同意后填写完整。与未手术儿童的家长相比,接受腺样体扁桃体切除术儿童的家长更有可能报告睡眠、呼吸和生活质量有所改善,但注意力、学业表现以及智力或发育进展方面没有改善。无论短期还是长期,腺样体扁桃体切除术对CPRS-R行为分量表均无显著影响。
从家长的角度来看,腺样体扁桃体切除术通常可改善睡眠、呼吸和生活质量,但并不常改善神经行为结果。