Departments of Otolaryngology, Children's Hospital of Pittsburgh, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania 15224, USA.
JAMA Otolaryngol Head Neck Surg. 2013 Feb;139(2):139-46. doi: 10.1001/jamaoto.2013.1331.
To investigate interventions used in treating obstructive sleep apnea in neonates and infants and to report their efficacies.
Retrospective medical record review.
Tertiary care children's hospital.
Neonates and infants aged 0 to 12 months at the time of obstructive sleep apnea diagnosis by polysomnography.
Demographic data, comorbidities, polysomnography data, and intervention data.
In total, 126 patients (86 [68.3%] male and 40 [31.7%] female) were included in the study. The most common interventions (and the mean age at the time of intervention) were anti-gastroesophageal reflux disease treatment (88 patients [69.8%] at age 7 months), observation (33 patients [26.2%] at age 6 months), supplemental oxygen (31 patients [24.6%] at age 4 months), adenoidectomy (30 patients [23.8%] at age 15 months), other surgical (25 patients [19.8%] at age 7 months), continuous positive airway pressure/bilevel positive airway pressure (CPAP/BiPAP) (18 patients [14.3%] at age 16 months), supraglottoplasty (11 patients [8.7%] at age 6 months), tonsillectomy and adenoidectomy (9 patients [7.1%] at age 24 months), tracheostomy (7 patients [5.6%] at age 10 months), and other nonsurgical (7 patients [5.6%] at age 15 months). Among neonates and infants, nonsurgical interventions were performed in most cases, although those aged 0 to 3 months underwent more surgical interventions (19.7%) than those aged older than 3 to 9 months (11.7%). The mean objective improvement, measured as a percentage decrease in preintervention to postintervention apnea-hypopnea index, was greatest in neonates and infants receiving CPAP/BiPAP, followed by those undergoing tracheostomy.
Anti-gastroesophageal reflux disease treatment is the most common intervention in each age group. Although adenoidectomy is the most common surgical intervention overall, the prevalence increases with age. Supraglottoplasty is the most common surgical intervention in neonates and infants aged 0 to 3 months and offers the greatest objective improvement in this age group. Overall, the use of CPAP/BiPAP is associated with the greatest objective improvement.
探讨治疗新生儿和婴儿阻塞性睡眠呼吸暂停的干预措施，并报告其疗效。
回顾性病历回顾。
三级儿童保健医院。
经多导睡眠图诊断为阻塞性睡眠呼吸暂停的 0 至 12 个月大的新生儿和婴儿。
人口统计学数据、合并症、多导睡眠图数据和干预措施数据。
共纳入 126 例患者（86 例[68.3%]为男性，40 例[31.7%]为女性）。最常见的干预措施（和干预时的平均年龄）是抗胃食管反流病治疗（88 例[69.8%]在 7 个月时）、观察（33 例[26.2%]在 6 个月时）、补充氧气（31 例[24.6%]在 4 个月时）、腺样体切除术（30 例[23.8%]在 15 个月时）、其他手术（25 例[19.8%]在 7 个月时）、持续气道正压通气/双水平气道正压通气（CPAP/BiPAP）（18 例[14.3%]在 16 个月时）、悬雍垂腭成形术（11 例[8.7%]在 6 个月时）、扁桃体切除术和腺样体切除术（9 例[7.1%]在 24 个月时）、气管切开术（7 例[5.6%]在 10 个月时）和其他非手术治疗（7 例[5.6%]在 15 个月时）。在新生儿和婴儿中，大多数情况下采用非手术干预，但 0 至 3 个月龄婴儿接受手术干预的比例（19.7%）高于 3 至 9 个月龄婴儿（11.7%）。以干预前后睡眠呼吸暂停低通气指数下降百分比衡量的客观改善程度，CPAP/BiPAP 治疗的新生儿和婴儿最大，其次是气管切开术。
抗胃食管反流病治疗是每个年龄组最常见的干预措施。虽然腺样体切除术是总体上最常见的手术干预，但随着年龄的增长，其患病率会增加。悬雍垂腭成形术是 0 至 3 个月龄新生儿和婴儿中最常见的手术干预措施，在该年龄组中提供最大的客观改善。总体而言，CPAP/BiPAP 的使用与最大的客观改善相关。
