Esteller Moré Eduard, Santos Acosta Paola, Segarra Isern Francesc, Lopez Diu Roser, Matiño Soler Eusebi, Ademà Alcover Joan Manel, Estivill Sancho Eduard
Servicio de Otorrinolaringología, Hospital General de Catalunya, San Cugat del Vallès, Barcelona, España.
Acta Otorrinolaringol Esp. 2012 Mar-Apr;63(2):85-92. doi: 10.1016/j.otorri.2011.08.004. Epub 2012 Feb 18.
Treatment of obstructive sleep apnoea-hypopnoea syndrome in children with adenotonsillectomy is effective but has a moderate rate of persistent disease.
To analyse the rate of persistence of sleep apnoea-hypopnoea syndrome in a group of adenotonsillectomy-treated paediatric patients and to assess the possible prognostic factors.
Prospective study of 80 patients aged between 2 and 13 years who had obstructive sleep apnoea-hypopnoea syndrome, treated with adenotonsillectomy. All patients had been followed up clinically and by polysomnography for 1 year after surgery. We analysed the epidemiological and clinical factors that could negatively affect the outcome of surgery.
The median age was 5.25 ± 2.05 years and the mean apnoea-hypopnoea index (AHI) was 8.13 ± 6.06. One year after surgery, all clinical parameters improved significantly and the mean AHI was 2.50. Persistent disease (AHI≥3) was present in 21 of the patients (26.3%). The comparative analysis of clinical and epidemiological factors between the group of non-persistence and persistence did not obtain statistically-significant differences in age, sex, tonsillar size, Friedman degree or severity of preoperative disease. The only significant factor was that patients without persistence were more obese.
The results of our study about the persistence of obstructive sleep apnoea-hypopnoea syndrome after adenotonsillectomy are significant enough to recommend follow-up with polysomnography, especially in high-risk groups. In the series presented here, we were not able to demonstrate these risk factors. Our results are probably conditioned by the characteristics of the population studied: Low age, low obesity rate and less severe levels of apnoea-hypopnoea index.
腺样体扁桃体切除术治疗儿童阻塞性睡眠呼吸暂停低通气综合征有效，但疾病持续存在的发生率中等。
分析一组接受腺样体扁桃体切除术治疗的儿科患者中睡眠呼吸暂停低通气综合征的持续发生率，并评估可能的预后因素。
对80例年龄在2至13岁之间、患有阻塞性睡眠呼吸暂停低通气综合征并接受腺样体扁桃体切除术的患者进行前瞻性研究。所有患者术后均接受了1年的临床随访和多导睡眠图监测。我们分析了可能对手术结果产生负面影响的流行病学和临床因素。
中位年龄为5.25±2.05岁，平均呼吸暂停低通气指数（AHI）为8.13±6.06。术后1年，所有临床参数均显著改善，平均AHI为2.50。21例患者（26.3%）存在持续性疾病（AHI≥3）。非持续性组和持续性组之间的临床和流行病学因素比较分析在年龄、性别、扁桃体大小、Friedman分级或术前疾病严重程度方面未获得统计学显著差异。唯一显著的因素是无持续性疾病的患者更肥胖。
我们关于腺样体扁桃体切除术后阻塞性睡眠呼吸暂停低通气综合征持续性的研究结果足以建议进行多导睡眠图随访，尤其是在高危人群中。在本系列研究中，我们未能证实这些危险因素。我们的结果可能受所研究人群特征的影响：年龄小、肥胖率低以及呼吸暂停低通气指数水平较轻。
