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儿童阻塞性睡眠呼吸暂停综合征与麻醉

Obstructive sleep apnoea syndrome in children and anaesthesia.

作者信息

Rudra A, Ray Manjushree, Sengupta S, Iqbal Asif, Maitra G, Chatterjee S

机构信息

Apollo Gleneagles Hospital, Kolkata, India.

出版信息

Indian J Anaesth. 2010 Jan;54(1):18-23. doi: 10.4103/0019-5049.60491.

Abstract

Obstructive sleep apnoea syndrome (OSAS) is a common medical disorder among adults, which is increasingly being recognized in children too. It is a breathing disorder characterized by upper airway obstruction with or without intermittent complete obstruction that disrupts normal breathing during sleep. Anatomical and neuromuscular disorders are mainly responsible for this disorder. This disorder leads to a state of chronic hypoxemia, which has significant cardiac, pulmonary and central nervous system implications. Diagnosis of OSAS is based on thorough history and clinical examination along with appropriate sleep studies including polysomnography. The mainstay of treatment of paediatric OSAS is adenotonsillectomy. Good anaesthetic practice in Paediatric patients with OSAS revolves around good and ideal airway management. Early detection of airway obstruction, intense monitoring to warn of impending airway problems and appropriate and early intervention of airway compromise are good anaesthetic practices. Coexisting medical problems should be adequately addressed and safe analgesic techniques in the perioperative period go towards improving outcomes in patients with paediatric OSAS.

摘要

阻塞性睡眠呼吸暂停综合征(OSAS)是成年人中常见的一种医学病症,在儿童中也越来越受到关注。它是一种呼吸障碍,其特征是上呼吸道阻塞,伴有或不伴有间歇性完全阻塞,从而扰乱睡眠期间的正常呼吸。解剖学和神经肌肉疾病是导致这种病症的主要原因。这种病症会导致慢性低氧血症状态,对心脏、肺部和中枢神经系统有重大影响。OSAS的诊断基于详尽的病史、临床检查以及包括多导睡眠图在内的适当睡眠研究。小儿OSAS的主要治疗方法是腺样体扁桃体切除术。患有OSAS的儿科患者的良好麻醉实践围绕着良好且理想的气道管理展开。早期发现气道阻塞、进行严密监测以警示即将出现的气道问题以及对气道受损进行适当且早期的干预,这些都是良好的麻醉实践。并存的医疗问题应得到充分处理,围手术期安全的镇痛技术有助于改善小儿OSAS患者的治疗效果。

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