儿童阻塞性睡眠呼吸暂停的持续气道正压通气治疗
Continuous positive airway pressure for obstructive sleep apnea in children.
作者信息
Wang Jessie J, Imamura Toshihiro, Lee James, Wright Marie, Goldman Ran D
出版信息
Can Fam Physician. 2021 Jan;67(1):21-23. doi: 10.46747/cfp.670121.
Abstract
QUESTION
A 12-year-old child underwent adenotonsillectomy for treatment of obstructive sleep apnea (OSA) but continues to snore at night and struggles with attentiveness at school. The child's parent uses a continuous positive airway pressure (CPAP) machine at night and wonders whether the same therapy could be used in children.
ANSWER
Unlike in adults, pediatric OSA is commonly related to adenotonsillar hypertrophy and is often amenable to treatment with adenotonsillectomy. As an alternative to surgery or in cases of postsurgical persistence of OSA, CPAP has shown effectiveness in improving both polysomnographic parameters and daytime neurobehavioural symptoms in children with OSA. Adherence to CPAP therapy is a challenge in children and requires parental education and special considerations such as a mask acclimatization period.
摘要
问题
一名12岁儿童接受了腺样体扁桃体切除术以治疗阻塞性睡眠呼吸暂停（OSA），但夜间仍打鼾，且在学校难以集中注意力。孩子的家长夜间使用持续气道正压通气（CPAP）机，想知道同样的疗法是否可用于儿童。
答案
与成人不同，小儿OSA通常与腺样体扁桃体肥大有关，且通常适合用腺样体扁桃体切除术治疗。作为手术的替代方法或在OSA术后持续存在的情况下，CPAP已显示出可有效改善小儿OSA患者的多导睡眠图参数和白天神经行为症状。坚持CPAP治疗对儿童来说是一项挑战，需要对家长进行教育并给予特殊考虑，如面罩适应期。
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本文引用的文献
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Medicine (Baltimore). 2017 Oct;96(42):e8281. doi: 10.1097/MD.0000000000008281.
2
Tonsillectomy or adenotonsillectomy versus non-surgical management for obstructive sleep-disordered breathing in children.扁桃体切除术或腺样体扁桃体切除术与非手术治疗对儿童阻塞性睡眠呼吸障碍的疗效比较
Cochrane Database Syst Rev. 2015 Oct 14;2015(10):CD011165. doi: 10.1002/14651858.CD011165.pub2.
3
A randomized trial of adenotonsillectomy for childhood sleep apnea.腺样体扁桃体切除术治疗儿童睡眠呼吸暂停的随机试验。
N Engl J Med. 2013 Jun 20;368(25):2366-76. doi: 10.1056/NEJMoa1215881. Epub 2013 May 21.
4
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5
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6
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