Coyle Paula, Marzouk Sherief Deya, Gerolympou Margarita, Marais Joe
Northwick Park, Harrow, Middlesex, UK.
Northwick Park, London, UK.
BMJ Case Rep. 2014 Jun 6;2014:bcr2013203378. doi: 10.1136/bcr-2013-203378.
Obstructive sleep apnoea is a common presentation in paediatric ear, nose and tongue (ENT) outpatients. The use of sleep studies is controversial however once a diagnosis has been made, frequently treatment is surgery. Should these patients be operated on as urgent cases? A 5-year-old boy was admitted under the paediatric team with difficultly breathing and desaturations to 77%. The patient had previously been seen by ENT as an outpatient with an 8-month history of obstructive sleep apnoea and was listed for an adenotonsillectomy with the standard waiting time. During this admission he had an emergency adenotonsillectomy. The patient improved immediately with no large desaturations in recovery and normal observations throughout his stay. It is never ideal to do a paediatric emergency operation and we have reviewed the evidence base to answer the question: Should these patients be treated urgently when seen in outpatients?
阻塞性睡眠呼吸暂停是儿科耳鼻喉门诊常见的病症。睡眠研究的应用存在争议，然而一旦确诊，通常的治疗方法是手术。这些患者是否应作为急症进行手术？一名5岁男孩被儿科团队收治，当时呼吸困难，血氧饱和度降至77%。该患者此前作为门诊患者看过耳鼻喉科，有8个月的阻塞性睡眠呼吸暂停病史，被列入腺样体扁桃体切除术名单，等待标准的手术时间。在此次住院期间，他接受了紧急腺样体扁桃体切除术。术后患者立即好转，恢复过程中没有出现大幅血氧饱和度下降，住院期间各项观察指标均正常。进行儿科急诊手术绝非理想之举，我们查阅了相关证据来回答这个问题：这些患者在门诊就诊时是否应进行紧急治疗？
