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儿童阻塞性睡眠呼吸暂停手术后的体重影响。

Impacts of body weight after surgery for obstructive sleep apnea in children.

机构信息

Department of Otolaryngology, National Taiwan University Hospital, Taipei, Taiwan.

出版信息

Int J Obes (Lond). 2013 Apr;37(4):527-31. doi: 10.1038/ijo.2012.194. Epub 2012 Nov 27.

Abstract

OBJECTIVE

To investigate the impacts of body weight status on surgical outcomes and shifts of body weight status after adenotonsillectomy(T&A) in children with obstructive sleep apnea (OSA).

METHODS

From 2009 to 2011, 161 children (mean age, 7.0 ± 3.4 years; 78% boys) were included. All the children had clinical symptoms and preoperative polysomnographic evaluations diagnosis of OSA. Children were divided into four weight status groups (underweight, normal weight, overweight and obese), based on age and gender corrected body mass index (BMI).

RESULTS

Following T&A, the four different weight status groups significantly improved in apnea/hypopnea index (AHI) and minimum oxygen saturation. However, 49.1% of the children (79/161) had residual OSA (AHI ≥ 1). The incidence of residual OSA (AHI ≥ 1) in the obese group was 75%, which was significantly higher than the other three groups (P<0.01). Weight status changes after T&A were documented, and 54% (13/24) of the underweight children shifted to normal weight status within 6 months after surgery.

CONCLUSION

Although sleep parameters improved in all weight statuses, obese children had a higher incidence of residual OSA postoperatively. About half of the underweight children shifted to normal weight status after T&A.

摘要

目的

研究体重状况对阻塞性睡眠呼吸暂停(OSA)患儿扁桃体腺样体切除术(T&A)后手术结果和体重变化的影响。

方法

2009 年至 2011 年间,共纳入 161 名儿童(平均年龄 7.0±3.4 岁,78%为男性)。所有儿童均有临床症状和术前多导睡眠图评估诊断为 OSA。根据年龄和性别校正后的体重指数(BMI),将儿童分为 4 个体重状况组(体重不足、正常体重、超重和肥胖)。

结果

T&A 后,4 个不同体重状况组的呼吸暂停/低通气指数(AHI)和最低血氧饱和度均显著改善。然而,79/161(49.1%)名儿童仍存在 OSA(AHI≥1)。肥胖组的残余 OSA(AHI≥1)发生率为 75%,明显高于其他三组(P<0.01)。记录 T&A 后的体重变化,24 名体重不足的儿童中有 13 名(54%)在术后 6 个月内体重转为正常。

结论

尽管所有体重状况的睡眠参数均有所改善,但肥胖儿童术后残余 OSA 的发生率较高。大约一半的体重不足儿童在 T&A 后体重转为正常。

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