Gajaweera H S, Griffiths C, Everitt L H, Evans H J
Paediatric Respiratory Department, Southampton Children's Hospital, Southampton, UK.
J Laryngol Otol. 2022 Mar 21:1-2. doi: 10.1017/S0022215121004230.
Severe paediatric obstructive sleep apnoea in typically developing children with adenotonsillar hypertrophy is primarily managed surgically. Non-emergency ENT surgery was paused early in the coronavirus disease 2019 pandemic and children were offered medical management for obstructive sleep apnoea.
A service evaluation was performed to assess the impact of continuous positive airway pressure alongside medical management for severe obstructive sleep apnoea.
Over 5 months during 2020, in a tertiary care setting, two children (one boy and one girl), aged 2.7 years and 4.1 years, were offered continuous positive airway pressure and medical treatments for severe obstructive sleep apnoea whilst surgery was paused during the coronavirus disease 2019 pandemic. Both children failed to establish continuous positive airway pressure therapy because of ongoing disturbed sleep on ventilation, and they proceeded to adenotonsillectomy. Sleep-Related Breathing Disorder scale scores improved following surgical intervention.
Continuous positive airway pressure therapy is poorly tolerated in children with severe obstructive sleep apnoea secondary to adenotonsillar hypertrophy. Surgery remains the most appropriate treatment.
对于患有腺样体扁桃体肥大的发育正常儿童，重度小儿阻塞性睡眠呼吸暂停主要通过手术治疗。在2019冠状病毒病大流行初期，非急诊耳鼻喉科手术暂停，为阻塞性睡眠呼吸暂停儿童提供药物治疗。
进行了一项服务评估，以评估持续气道正压通气联合药物治疗对重度阻塞性睡眠呼吸暂停的影响。
在2020年的5个多月里，在一家三级医疗机构中，两名年龄分别为2.7岁和4.1岁的儿童（一名男孩和一名女孩）在2019冠状病毒病大流行期间手术暂停时，接受了持续气道正压通气和药物治疗以治疗重度阻塞性睡眠呼吸暂停。由于通气时睡眠持续受到干扰，两名儿童均未能成功进行持续气道正压通气治疗，随后他们接受了腺样体扁桃体切除术。手术干预后，睡眠相关呼吸障碍量表评分有所改善。
对于腺样体扁桃体肥大继发的重度阻塞性睡眠呼吸暂停儿童，持续气道正压通气治疗的耐受性较差。手术仍然是最合适的治疗方法。
