Department of Otolaryngology, St Mary's Hospital, Imperial Healthcare NHS Trust, London, UK.
Clin Otolaryngol. 2011 Oct;36(5):475-81. doi: 10.1111/j.1749-4486.2011.02383.x.
To assess a cohort of patients who underwent adenotonsillectomy for obstructive sleep apnoea, 4 years after surgery for evidence of continued and long-term improvement in quality of life. We also sought to compare our results to Child Health Questionnaire scores obtained from our previous study. We also compared our data with a healthy UK children population from normative data available.
Longitudinal study.
University Hospital Tertiary Referral Centre.
A 4-year follow-up study of 37 children who underwent adenotonsillectomy for obstructive sleep apnoea confirmed on polysomnography. There were 19 boys and 18 girls from our initial cohort. The primary caregiver completed the validated Child Health Questionnaire Parental Form version-28, 4 years after initial surgery. Our control group consist of 221 healthy children aged 6-18 that were included as 'normal' controls in a study looking at children with juvenile arthritis. The children were defined as healthy by a physician and/or after declaration by the parent.
Child Health Questionnaire Parental Form version-28 scores.
A total of 33 patients (89%) from our initial cohort were contacted. The mean age was 10.6 (median, 11; range, 5-16). When compared with results obtained 3 months postoperatively, the mean scores were higher in five domains and were statistically significant in three subscales (Role Limitations P < 0.00001; Bodily Pain P < 0.002; and Global Health P < 0.02). There was a significant deterioration in Behaviour subscale (P < 0.0007) in spite of surgery. Compared with controls, 4-year follow-up scores were higher in five domains with the Global Health domain (P < 0.0004) being statistically significant. When the 4-year follow-up scores were compared with preoperative values, these were higher in all 13 domains with statistically significant improvements in nine domains, indicating that improvements had persisted 4 years after surgery. At 4 years, however, the means scores in many domains remain lower when compared with controls.
Quality-of-life data are an important measure when deciding on a specific clinical intervention. In the short term, quality-of-life measures have been shown to improve after adenotonsillectomy for obstructive sleep apnoea. Our study demonstrates that the benefits of surgery are still persistent and the children continue to improve in the long term.
评估一组因阻塞性睡眠呼吸暂停而行腺样体扁桃体切除术的患者，在术后 4 年时的生活质量是否持续改善。我们还试图将我们的结果与之前研究中获得的儿童健康问卷评分进行比较。我们还将我们的数据与来自现有规范数据的英国健康儿童群体进行了比较。
纵向研究。
大学医院三级转诊中心。
对 37 名经多导睡眠图证实的阻塞性睡眠呼吸暂停患者进行腺样体扁桃体切除术的 4 年随访研究。这是我们最初队列中的 19 名男孩和 18 名女孩。主要照顾者在初始手术后 4 年完成了经过验证的儿童健康问卷家长版 28 分。我们的对照组包括 221 名年龄在 6-18 岁的健康儿童，他们在一项研究青少年关节炎儿童的研究中被定义为“正常”对照组。医生和/或父母声明后，这些儿童被定义为健康。
儿童健康问卷家长版 28 分。
我们联系了最初队列中的 33 名患者（89%）。平均年龄为 10.6 岁（中位数为 11 岁；范围为 5-16 岁）。与术后 3 个月的结果相比，五个领域的平均得分更高，三个亚量表的得分具有统计学意义（角色限制 P <0.00001；躯体疼痛 P <0.002；和全球健康 P <0.02）。尽管进行了手术，但行为亚量表仍显著恶化（P <0.0007）。与对照组相比，4 年随访时五个领域的评分较高，其中全球健康领域（P <0.0004）具有统计学意义。将 4 年随访评分与术前值进行比较时，13 个领域的评分均升高，9 个领域的评分具有统计学意义改善，表明手术后 4 年仍保持改善。然而，与对照组相比，在许多领域的平均分数仍较低。
在决定特定临床干预措施时，生活质量数据是一个重要的衡量标准。短期来看，腺样体扁桃体切除术治疗阻塞性睡眠呼吸暂停后，生活质量得到了改善。我们的研究表明，手术的益处仍然持续存在，儿童在长期内仍在不断改善。
