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12个月以下儿童的无创正压通气治疗

Noninvasive Positive Airway Pressure Treatment in Children Less Than 12 Months of Age.

作者信息

Adeleye Adetayo, Ho Alice, Nettel-Aguirre Alberto, Buchhalter Jeffrey, Kirk Valerie

机构信息

Division of Respiratory Medicine, Alberta Children's Hospital, 2888 Shaganappi Trail NW, Calgary, AB, Canada T3B 6A8.

Division of Neurology, Alberta Children's Hospital, 2888 Shaganappi Trail NW, Calgary, AB, Canada T3B 6A8.

出版信息

Can Respir J. 2016;2016:7654631. doi: 10.1155/2016/7654631. Epub 2016 Jun 15.

Abstract

Study Objectives. We identified the associated conditions of patients less than 12 months of age who were referred for polysomnogram (PSG) studies. We collated PSG findings and physician interpretation. We determined the correlation between the recommended treatment by the PSG interpreting physician and actual prescribed treatment by the referring or subjects' physician. We determined adherence with noninvasive positive airway pressure (PAP) treatment. Methods. This was a retrospective cohort study. Participants included children less than 12 months of age referred for PSG studies between 2007 and 2012. Results. 92 patients under the age of 12 months were included in the study analysis. Mean (standard deviation, SD) age in days at time of the PSG study was 208.5 (101.2). 35 (38%) patients had a diagnosis of Trisomy 21. Seven (8%) patients had no prior diagnosis. Median (Q1, Q3) apnea hypopnea index (AHI) was 22.5 (11.3-37.0). Agreement between the PSG interpreting physician's recommendation and actual prescribed treatment by the referring or subjects' physician was 85.9% [95% CI 77.1-91.6]. Mean (SD) percentage days with PAP therapy usage more than 4 hours was 25.2% (32). Conclusions. In our experience, despite consistent physician messaging to families, adherence with noninvasive PAP treatment is low.

摘要

研究目的。我们确定了被转诊进行多导睡眠图(PSG)检查的12个月以下患儿的相关病症。我们整理了PSG检查结果及医生的解读。我们确定了PSG解读医生建议的治疗方法与转诊医生或患儿医生实际开出的治疗方法之间的相关性。我们确定了无创正压通气(PAP)治疗的依从性。方法。这是一项回顾性队列研究。参与者包括2007年至2012年间被转诊进行PSG检查的12个月以下儿童。结果。92名12个月以下的患儿纳入了研究分析。PSG检查时的平均(标准差,SD)年龄为208.5天(101.2天)。35名(38%)患儿被诊断为21三体综合征。7名(8%)患儿此前未被诊断。呼吸暂停低通气指数(AHI)的中位数(第一四分位数,第三四分位数)为22.5(11.3 - 37.0)。PSG解读医生的建议与转诊医生或患儿医生实际开出的治疗方法之间的一致性为85.9%[95%置信区间77.1 - 91.6]。PAP治疗使用超过4小时的平均(SD)天数百分比为25.2%(32)。结论。根据我们的经验,尽管医生向家庭传达了一致的信息,但无创PAP治疗的依从性较低。

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