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[阻塞性睡眠呼吸暂停低通气综合征]

[Obstructive sleep apnoea syndrome].

作者信息

García Castillo Sergio, Hoyos Vázquez María Del Perpetuo Socorro, Coloma Navarro Ramón, Cruz Ruiz Javier, Callejas González Francisco Javier, Godoy Mayoral Raúl, Tárraga López Pedro Juan, Rodríguez Montes José Antonio

机构信息

Servicio de Neumología, Complejo Hospitalario Universitario de Albacete, Albacete, España.

Servicio de Pediatría, Complejo Hospitalario Universitario de Albacete, Albacete, España.

出版信息

An Pediatr (Engl Ed). 2018 May;88(5):266-272. doi: 10.1016/j.anpedi.2017.07.004. Epub 2017 Aug 24.

Abstract

INTRODUCTION

Obstructive sleep apnoea (OSA) is highly prevalent in children and a major public health problem. An attempt is made to determine the clinical and polysomnographic presentation of paediatric OSA in our area.

PATIENTS AND METHODS

Retrospective descriptive study of sleep tests conducted on children up to 14 years-old from 1999 to 2012 in the Sleep Unit of the University Hospital of Albacete. Age, gender, anthropometric, clinical data, indication and variables of sleep study, treatment, and outcomes were collected.

RESULTS

The study included 234 children. OSA was found in 71.8%, with 42.3% moderate and 44.6% severe. The majority were male (60.7%) and the mean age 5 was years, of whom 78% were pre-school or school age. There was overweight/obesity in 44%, with 93.4% snoring, apnoea 84.5%, and 5.4% daytime sleepiness. There were 23 polysomnographies and 145 polygraphies, with a median apnoea/hypopnoea index (AHI) of 10, Sat.O2 minimum 84%, desaturation index 8, and mean sleep supine 53.65% and supine events 57.61%. Treatment was lifestyle modifications 29.2%, CPAP 6%, and surgery 42.9%. Improved snoring and/or apnoea 69.4%, and weight 32.4% of overweight/obesity children.

CONCLUSIONS

Most of the studied children had a pathological AHI. Almost half were overweight/obese, and a high percentage had moderate-severe OSA. Most frequent treatment was surgery. The clinical outcome was favourable in almost 70%. Less than a third with OSA and overweight/obesity improved weight.

摘要

引言

阻塞性睡眠呼吸暂停(OSA)在儿童中非常普遍,是一个重大的公共卫生问题。本文旨在确定我们地区小儿OSA的临床和多导睡眠图表现。

患者与方法

对1999年至2012年在阿尔巴塞特大学医院睡眠科接受睡眠测试的14岁以下儿童进行回顾性描述性研究。收集了年龄、性别、人体测量学、临床数据、睡眠研究的指征和变量、治疗方法及结果。

结果

该研究纳入了234名儿童。发现71.8%的儿童患有OSA,其中42.3%为中度,44.6%为重度。大多数为男性(60.7%),平均年龄为5岁,其中78%为学龄前或学龄儿童。44%的儿童超重/肥胖,93.4%的儿童打鼾,84.5%的儿童有呼吸暂停,5.4%的儿童有白天嗜睡。有23次全夜多导睡眠图和1个月多导睡眠监测,呼吸暂停/低通气指数(AHI)中位数为10,最低血氧饱和度(Sat.O2)为84%,血氧饱和度下降指数为8,平均仰卧睡眠率为53.65%,仰卧位事件发生率为57.61%。治疗方法包括生活方式改变(29.2%)、持续气道正压通气(CPAP,6%)和手术(42.9%)。69.4%的儿童打鼾和/或呼吸暂停情况改善,超重/肥胖儿童中有32.4%的体重减轻。

结论

大多数研究儿童的AHI病理性升高。近一半儿童超重/肥胖,且高比例儿童患有中重度OSA。最常用的治疗方法是手术。近70%的临床结果良好。OSA合并超重/肥胖的儿童中,体重减轻的不到三分之一。

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