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儿童睡眠呼吸障碍——诊断问卷、比较分析

Sleep disordered breathing in children - Diagnostic questionnaires, comparative analysis.

作者信息

Burghard Marcin, Brożek-Mądry Eliza, Krzeski Antoni

机构信息

Medical Center in Ostrołęka, Branch in Różan, Poland.

Medical University of Warsaw, Faculty of Medicine and Dentistry, Department of Otorhinolaryngology, Poland.

出版信息

Int J Pediatr Otorhinolaryngol. 2019 May;120:108-111. doi: 10.1016/j.ijporl.2019.02.008. Epub 2019 Feb 5.

Abstract

STUDY OBJECTIVES

The purpose of this work is to present available questionnaires enabling diagnostic screening when obstructive sleep disordered breathing (SDB) in a child is suspected or its effects are observed and polysomnography is unavailable. These questionnaires are designed to facilitate further diagnostic process or even therapeutic decisions, aid in selecting the optimal one for the specified conditions of clinical practice, with the caveat that none of these represents a diagnostic equivalent to PSG.

METHODS

The questionnaires subjected to analysis: Pediatric Sleep Questionnaire (PSQ), Sleep Clinical Record (SCR), OSA-18 score (OSA-18), Brouilette score (BS), "I'm Sleepy" questionnaire (I'M SLEEPY), and "Sleeping Sleepless Sleepy Disturbed Rest" questionnaire (SSSDR). The comparative analysis of questionnaires included the following parameters: simplicity and time of administer; necessity to engage a physician or other trained individual; taking into account examination of the patient; type and scope of considered symptoms and consequences of obstructive SDB, sensitivity, specificity, recommendations of the guidelines.

RESULTS

Seven questionnaires were subjected to analysis with presentation of their similarities and differences. Six out of seven were evaluated as simple in administration. Time required to fulfill the questionnaires ranged between 1 and 60 min. Three of them involved a physician or a trained personnel. Physical examination was necessary in two out of seven questionnaires. Sensitivity was estimated in 5 of them and ranged between 59 and 96%. Specificity ranged between 46 and 72%.

CONCLUSIONS

Several questionnaires enabling quick, simple, and inexpensive screening for OSAS have been created. Four (of the seven analyzed) questionnaires may be useful in diagnosis of obstructive SDB in children - two follow current (2015) recommendations. However, there is a need for further work on optimizing such tools, particularly on improving their specificity.

摘要

研究目的

本研究旨在介绍一些可用的问卷,以便在怀疑儿童患有阻塞性睡眠呼吸障碍(SDB)或观察到其影响且无法进行多导睡眠图检查时进行诊断性筛查。这些问卷旨在促进进一步的诊断过程甚至治疗决策,帮助在临床实践的特定条件下选择最佳问卷,但需注意这些问卷均不能等同于多导睡眠图检查的诊断结果。

方法

分析的问卷包括:儿童睡眠问卷(PSQ)、睡眠临床记录(SCR)、OSA - 18评分(OSA - 18)、布鲁耶特评分(BS)、“我很困”问卷(I'M SLEEPY)以及“睡眠、失眠、困倦、不安、休息”问卷(SSSDR)。问卷的比较分析包括以下参数:简单性和施测时间;是否需要医生或其他受过培训的人员参与;是否考虑对患者进行检查;所考虑的阻塞性SDB症状和后果的类型及范围、敏感性、特异性、指南建议。

结果

对七份问卷进行了分析,展示了它们的异同。七份问卷中有六份被评估为施测简单。完成问卷所需时间在1至60分钟之间。其中三份需要医生或经过培训的人员参与。七份问卷中有两份需要进行体格检查。其中五份评估了敏感性,范围在59%至96%之间。特异性在46%至72%之间。

结论

已经创建了几份能够快速、简单且低成本筛查阻塞性睡眠呼吸暂停综合征(OSAS)的问卷。(在分析的七份问卷中)有四份问卷可能对儿童阻塞性SDB的诊断有用——其中两份符合当前(2015年)的建议。然而,需要进一步开展工作来优化此类工具,特别是提高它们的特异性。

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