Wei Julie L, Bond Justin, Mayo Matthew S, Smith Holly J, Reese Matt, Weatherly Robert A
Department of Otolaryngology-Head and Neck Surgery, University of Kansas Medical Center, 3901 Rainbow Blvd, Mail Stop 3010, Kansas City, KS 66160, USA.
Arch Otolaryngol Head Neck Surg. 2009 Jul;135(7):642-6. doi: 10.1001/archoto.2009.74.
To determine whether previously published changes are maintained over time in children after adenotonsillectomy for sleep-disordered breathing using the validated Pediatric Sleep Questionnaire (PSQ) and the Conners Parent Rating Scale-Revised: Short Form (CPRS-R:S).
Prospective, nonrandomized interventional study.
Ambulatory surgery center affiliated with an academic medical center.
Long-term follow-up data were available (ranging from 2.4 to 3.6 years after adenotonsillectomy) for 44 of the 71 patients who completed our initial study comparing PSQ and CPRS-R:S data before and 6 months after surgery.
Parents completed the PSQ and CPRS-R:S at least 2 years after surgery.
Follow-up PSQ data and long-term changes in age- and sex-adjusted T scores for all 4 CPRS-R:S behavior categories (oppositional behavior, cognitive problems or inattention, hyperactivity, and the attention-deficit/hyperactivity disorder [ADHD] index) were determined for each patient. Linear mixed models were used to analyze the data.
Globally, across time, most variables remained below baseline levels (P < .05). There was a significant increase in PSQ scores during follow-up, but over this period they did not reach baseline levels. Comparing short-term with long-term follow-up, the Conners scores in all behavioral categories did not increase significantly (ADHD index, P = .61; cognitive problems or inattention, P = .02; hyperactivity, P < .001; and oppositional behavior, P < .001). The ADHD index at long-term follow-up was not different from that at baseline, a finding that might be attributable to the high degree of variability in this measure.
Improvements in sleep experienced by children after adenotonsillectomy for sleep-disordered breathing were not as great 2.5 years after surgery as they were 6 months after surgery but were still significant compared with baseline levels. Improvements in behavior were maintained in all categories of the Conners scores except for the ADHD index.
使用经过验证的儿童睡眠问卷（PSQ）和修订版康纳斯父母评定量表简表（CPRS-R:S），确定因睡眠呼吸障碍接受腺样体扁桃体切除术的儿童，之前公布的术后变化是否会随时间推移而持续存在。
前瞻性、非随机干预性研究。
一所学术医疗中心附属的门诊手术中心。
在完成我们最初比较PSQ和CPRS-R:S术前及术后6个月数据的研究的71名患者中，44名患者有长期随访数据（腺样体扁桃体切除术后2.4至3.6年）。
家长在术后至少2年完成PSQ和CPRS-R:S。
确定每位患者的随访PSQ数据以及所有4个CPRS-R:S行为类别（对立行为、认知问题或注意力不集中、多动以及注意力缺陷/多动障碍[ADHD]指数）年龄和性别调整T分数的长期变化。使用线性混合模型分析数据。
总体而言，随着时间推移，大多数变量仍低于基线水平（P <.05）。随访期间PSQ评分显著增加，但在此期间未达到基线水平。比较短期和长期随访，所有行为类别的康纳斯评分均未显著增加（ADHD指数，P =.61；认知问题或注意力不集中，P =.02；多动，P <.001；对立行为，P <.001）。长期随访时的ADHD指数与基线时无差异，这一发现可能归因于该指标的高度变异性。
因睡眠呼吸障碍接受腺样体扁桃体切除术的儿童，术后2.5年的睡眠改善程度不如术后6个月，但与基线水平相比仍很显著。除ADHD指数外，康纳斯评分的所有类别行为改善均得以维持。
