Daniel M, Bailey S, Walker K, Hensley R, Kol-Castro C, Badawi N, Cheng A, Waters K
Children's Hospital, Westmead, Sydney, Australia.
Int J Pediatr Otorhinolaryngol. 2013 Apr;77(4):499-503. doi: 10.1016/j.ijporl.2012.12.019. Epub 2013 Jan 11.
Robin sequence (RS) is associated with airway abnormalities that result in functional problems of obstructive sleep apnoea (OSA), feeding difficulties, and consequent poor growth. We evaluated the relationships between OSA severity, airway and feeding interventions, and weight at 12 months in infants with RS and OSA.
Retrospective notes review of children with RS managed at our neonatal unit (1998-2010, inclusive).
Of 39 infants studied, 10 (25.6%) had mild/moderate OSA, and 29 (74.4%) severe. Infants with severe OSA required more airway interventions in hospital (82.8 vs 30.0%, p = 0.004) and at discharge (72.4 vs 20.0%, p = 0.007) than those with mild/moderate OSA; 30.0% of infants with mild/moderate OSA required continuous positive airway pressure (CPAP) during admission and 20.0% on discharge, but amongst those with severe OSA 82.8% required airway interventions as an inpatient, 17.2% underwent mandibular distraction osteogenesis, and 55.2% required CPAP on discharge. Those with severe OSA were also more likely to require tube feeding on discharge (89.7 vs 50.0%, p = 0.02). Overall, children were on a lower weight centiles at discharge compared to birth (-10.2 centiles) and at 12 months of age compared to birth (-14.8 centiles), but this occurred irrespective of OSA severity or need for airway interventions or tube feeding.
Infants with RS commonly have OSA, feeding and airway difficulties. Weight at 12 months appeared not to be influenced by OSA severity, feeding or airway problems, suggesting that current intervention/management strategy results in the severely affected infants growing as well as those affected less severely.
罗宾序列征（RS）与气道异常相关，可导致阻塞性睡眠呼吸暂停（OSA）功能问题、喂养困难及随之而来的生长发育不良。我们评估了RS合并OSA婴儿的OSA严重程度、气道及喂养干预措施与12月龄时体重之间的关系。
对在我们新生儿科接受治疗的RS患儿（1998年至2010年，含1998年和2010年）进行回顾性病历审查。
在研究的39例婴儿中，10例（25.6%）患有轻度/中度OSA，29例（74.4%）患有重度OSA。与轻度/中度OSA婴儿相比，重度OSA婴儿在住院期间（82.8%对30.0%，p = 0.004）和出院时（72.4%对20.0%，p = 0.007）需要更多的气道干预；30.0%的轻度/中度OSA婴儿在入院期间需要持续气道正压通气（CPAP），20.0%在出院时需要，而在重度OSA婴儿中，82.8%住院时需要气道干预，17.2%接受下颌骨牵张成骨术，55.2%出院时需要CPAP。重度OSA婴儿出院时也更有可能需要管饲喂养（89.7%对50.0%，p = 0.02）。总体而言，与出生时相比，患儿出院时体重百分位数较低（-10.2个百分位数），12月龄时与出生时相比体重百分位数更低（-14.8个百分位数），但这与OSA严重程度、气道干预需求或管饲喂养无关。
RS婴儿通常存在OSA、喂养及气道困难。12月龄时的体重似乎不受OSA严重程度、喂养或气道问题的影响，这表明当前的干预/管理策略能使重度受影响婴儿与轻度受影响婴儿生长情况相同。
