Lee Chia-Hsuan, Kang Kun-Tai, Weng Wen-Chin, Lee Pei-Lin, Hsu Wei-Chung
Department of Otolaryngology, Taipei Hospital, Ministry of Health and Welfare, New Taipei City, Taiwan; Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, Taiwan.
Department of Otolaryngology, Taipei Hospital, Ministry of Health and Welfare, New Taipei City, Taiwan; Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, Taiwan; Department of Otolaryngology, National Taiwan University Hospital, Taipei, Taiwan.
Int J Pediatr Otorhinolaryngol. 2015 Feb;79(2):210-5. doi: 10.1016/j.ijporl.2014.12.011. Epub 2014 Dec 16.
To assess short-term and long-term changes in quality of life after adenotonsillectomy (T&A) in children with obstructive sleep apnea (OSA).
Children aged 2-18 years old were enrolled. All subjects had clinical symptoms, overnight polysomnography diagnosis of OSA, and received T&A as treatment. Caregivers were asked to complete the OSA-18 survey before surgery, within 6 months after surgery (short-term), and more than 6 months after surgery (long-term).
A total of 114 children were included (mean age, 7.0±3.5 years; 75% boys). The mean OSA-18 total score was 71.5±16.0 before surgery. After surgery, the mean OSA-18 total score was significantly decreased in both the short-term (40.3±12.2, p<0.001) and the long-term (42.0±13.7, p<0.001). All five OSA-18 domains were also significantly decreased during short-term and long-term postoperative follow up (p<0.001). Short-term and long-term outcomes were compared. Mean OSA-18 total scores, sleep disturbance score, emotional distress score, daytime function score, and caregiver concerns score did not differ significantly between the short-term and long-term periods, while the physical symptom score was slightly higher in the long-term than the short-term period (9.7±3.3 vs. 8.7±3.0, p=0.02). Additionally, the physical symptoms score was higher in the long-term period in the female (p=0.01), older age (>6 years) (p=0.03), and non-obese (p=0.04) subgroups.
T&A improves short-term and long-term quality of life in children with OSA. Nevertheless, caregivers observed children with aggravation of physical symptoms of quality of life during long-term follow up, especially in the female, older, and non-obese subgroups.
评估阻塞性睡眠呼吸暂停(OSA)患儿行腺样体扁桃体切除术(T&A)后生活质量的短期和长期变化。
纳入2至18岁的儿童。所有受试者均有临床症状,经夜间多导睡眠图诊断为OSA,并接受T&A治疗。要求照顾者在手术前、手术后6个月内(短期)和手术后6个月以上(长期)完成OSA-18调查问卷。
共纳入114名儿童(平均年龄7.0±3.5岁;75%为男孩)。术前OSA-18总分平均为71.5±16.0。术后,短期(40.3±12.2,p<0.001)和长期(42.0±13.7,p<0.001)的OSA-18总分均显著降低。在术后短期和长期随访期间,OSA-18的所有五个领域也均显著降低(p<0.001)。对短期和长期结果进行比较。短期和长期的OSA-18总分、睡眠障碍评分、情绪困扰评分、日间功能评分和照顾者关注评分无显著差异,而长期的身体症状评分略高于短期(9.7±3.3对8.7±3.0,p=0.02)。此外,在女性(p=0.01)、年龄较大(>6岁)(p=0.03)和非肥胖(p=0.04)亚组中,长期的身体症状评分更高。
T&A可改善OSA患儿的短期和长期生活质量。然而,照顾者在长期随访中观察到患儿生活质量的身体症状有所加重,尤其是在女性、年龄较大和非肥胖亚组中。