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[小儿多导睡眠图:六年经验]

[Pediatric polygraphy: A 6-year experience].

作者信息

Zenteno Daniel, Verbal Daniela, Navarro Ximena, Torres Gerardo, Rivas-B Carla, Rodríguez-Núñez Iván, Elso María-José, Tapia Jaime

机构信息

Servicio de Pediatría, Hospital Guillermo Grant Benavente, Concepción, Chile.

Departamento de Pediatría, Facultad de Medicina, Universidad de Concepción, Chile.

出版信息

Rev Chil Pediatr. 2019 Jun;90(3):309-315. doi: 10.32641/rchped.v90i3.769.

Abstract

INTRODUCTION

The early diagnosis of Sleep Disordered Breathing (SDB) may allow proper intervention. Currently, polygraphy (PG) is a reliable and accessible alternative.

OBJECTIVE

To describe and analyze the PG of children > 1 year old with suspicion of SDB.

PATIENTS AND METHOD

PG of children > 1 year old and adolescents from Concepcion, Chile, with suspected SDB were included, from December 2011 to Au gust 2017. Demographic, clinical and polygraphic variables were collected. It was used descriptive sta tistics, expressing results in median and range. The association between apnea-hypopnea index (AHI) and oxygen saturation was determined by Spearman's Rho, considering significance of p < 0.05. Re sults: 190 studies were analyzed. Age 7.9 years old (1.0-20.6), 61% males.

DIAGNOSIS

neuromuscular disease (NMD) (24.2%), chronic lung damage (21.1%), upper airway obstruction (UAO) (19.5%), neurological damage (11%), Down syndrome (8.9%), upper airway malformations (7.4%), central hypoventilation (3.7%), obesity (2.6%), and others (1.6%). 55.3% were altered PG, with 53.3% of mild Obstructive Sleep Apnea Hypopnea Syndrome (OSAHS), 30.5% moderate, and 16.2% severe. There were no significant differences in AHI between groups of pathologies (p = 0.032), highlighting a higher AHI in obese patients 9 (0.41-51), and those with NMD 23.9 (0.4-36.6). It was found asso ciation between AHI and oxygen saturation parameters: mean saturation (rho = -0.425; p = 0.001), minimum (rho = -0.654; p = 0.001), and oxygen saturation below 90% (rho = 0.323; p = 0.001) in the whole sample.

DISCUSSION

There was a high percentage of OSAHS in at-risk pediatric patients, especially in those with NMD and obesity. PG is an accessible and implementable tool in a public hospital, a situation that can potentially be extrapolated to other healthcare centers.

摘要

引言

睡眠呼吸障碍(SDB)的早期诊断有助于进行适当干预。目前,多导睡眠图(PG)是一种可靠且可及的诊断方法。

目的

描述并分析疑似患有SDB的1岁以上儿童的多导睡眠图。

患者与方法

纳入2011年12月至2017年8月间来自智利康塞普西翁、疑似患有SDB的1岁以上儿童及青少年。收集人口统计学、临床及多导睡眠图变量。采用描述性统计,结果以中位数和范围表示。采用Spearman等级相关系数确定呼吸暂停低通气指数(AHI)与血氧饱和度之间的关联,p<0.05具有统计学意义。结果:共分析190项研究。年龄7.9岁(1.0 - 20.6岁),61%为男性。

诊断

神经肌肉疾病(NMD)(24.2%)、慢性肺损伤(21.1%)、上气道阻塞(UAO)(19.5%)、神经损伤(11%)、唐氏综合征(8.9%)、上气道畸形(7.4%)、中枢性低通气(3.7%)、肥胖(2.6%)及其他(1.6%)。55.3%的多导睡眠图结果异常,其中53.3%为轻度阻塞性睡眠呼吸暂停低通气综合征(OSAHS),30.5%为中度,16.2%为重度。不同病理组间AHI无显著差异(p = 0.032),肥胖患者(AHI为9(0.41 - 51))及NMD患者(AHI为23.9(0.4 - 36.6))的AHI较高。在整个样本中发现AHI与血氧饱和度参数之间存在关联:平均饱和度(rho = -0.425;p = 0.001)、最低饱和度(rho = -0.654;p = 0.001)以及血氧饱和度低于90%(rho = 0.323;p = 0.001)。

讨论

高危儿科患者中OSAHS的比例较高,尤其是患有NMD和肥胖的患者。多导睡眠图是公立医院可及且可实施的工具,这种情况可能推广至其他医疗中心。

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