Sjölander Isabella, Borgström Anna, Larsson Jan-Olov, Smedje Hans, Friberg Danielle
Department of Surgical Sciences, Otorhinolaryngology-Head and Neck Surgery, Uppsala University, Uppsala, Sweden.
Department of Clinical Science, Intervention and Technology, CLINTEC, Karolinska Institutet, Stockholm, Sweden.
Acta Paediatr. 2020 Oct;109(10):2099-2104. doi: 10.1111/apa.15210. Epub 2020 Mar 6.
Our previous randomised controlled trial of children with obstructive sleep apnoea (OSA) showed no significant differences between adenotonsillectomy (ATE) and adenotonsillotomy (ATT) in improving nocturnal respiration and quality of life after 1 year. The aim of this report was to evaluate the effects on behavioural symptoms using the Strengths and Difficulties Questionnaire (SDQ).
Children between 2 and 6 years with OSA were randomised to ATT or ATE. Parents, blinded to method, answered the SDQ while their child underwent polysomnography before and 1 year after surgery. Differences between the total SDQ scores were analysed between the treatment groups.
The SDQ was filled out in 87% of the cases preoperatively, and in 86% postoperatively. At follow-up, the mean total SDQ score was 9.6 SD ± 5.1 in the ATE group (n = 31), and 8.2 ± 6.7 in the ATT group (n = 37), P = .09. The mean total SDQ score for all was preoperatively 10.6 ± 5.0, and postoperatively 8.8 ± 6.0, P = .0002.
There were no significant differences in SDQ scores between the groups at follow-up, indicating that the more conservative ATT is a treatment option in paediatric OSA. The whole group of patients showed a significant improvement after surgery.
我们之前针对阻塞性睡眠呼吸暂停（OSA）儿童的随机对照试验表明，腺样体扁桃体切除术（ATE）和腺样体扁桃体切开术（ATT）在改善夜间呼吸及1年后的生活质量方面无显著差异。本报告旨在使用长处与困难问卷（SDQ）评估对行为症状的影响。
将2至6岁的OSA儿童随机分为ATT组或ATE组。对手术方式不知情的家长在孩子术前及术后1年进行多导睡眠图检查时填写SDQ。分析治疗组之间SDQ总分的差异。
87%的病例在术前填写了SDQ，术后这一比例为86%。随访时，ATE组（n = 31）的SDQ总分均值为9.6标准差±5.1，ATT组（n = 37）为8.2±6.7，P = 0.09。所有患者术前SDQ总分均值为10.6±5.0，术后为8.8±6.0，P = 0.0002。
随访时两组的SDQ评分无显著差异，表明更为保守的ATT是小儿OSA的一种治疗选择。整组患者术后均有显著改善。
