新西兰奥克兰地区儿科患者的 CPAP 治疗：2005-2020 年首都和海岸区卫生局（Capital and Coast DHB）发展中服务的审计。

CPAP for paediatric patients in Aotearoa New Zealand: audit of a developing service at Capital and Coast DHB 2005-2020.

机构信息

Professor and HOD, Department of Paediatrics and Child Health, University of Otago, Wellington, Child Health Services, Capital and Coast DHB.

Medical Student (at time study undertaken), Otago Medical School.

出版信息

N Z Med J. 2022 Apr 14;135(1553):62-71.

PMID:35728205

Abstract

AIMS

To document the establishment of a Paediatric Continuous Positive Airway Pressure (CPAP) service within the Wellington Region, and review outcomes over the last 15 years.

METHODS

A retrospective audit of the Paediatric Sleep Service records including clinic letters and polysomnography (PSG) studies for all paediatric patients commenced on CPAP treatment, or for whom CPAP treatment was offered, from November 2005 to December 2020. Data were collected on demographics, medical diagnoses, indications for respiratory support, ENT involvement and surgery. Factors related to CPAP use were also recorded.

RESULTS

Seventy-four children were offered CPAP in the time frame, 52 (70%) male. The age range at onset of CPAP treatment was <1 year of age to 23 years with 12 cases ≥16 years of age. There were 3 (4%) cases presenting before 2006, 11 (15%) cases from 2006-2010, 16 (22%) cases from 2011-2015 and 44 (59%) cases between 2016-2020. Ethnicities included were, 32 (43%) NZ European, 18 (24%) Māori, 19 (26%) Pacific and 5 (7%) Indian/Asian. The most common primary diagnoses were Obesity 21 (28%), Down Syndrome 10 (14%) and Craniofacial abnormalities 8 (11%). One family declined a CPAP trial and there were eight failed CPAP trials. For the remaining 65 patients, compliance with treatment was good/usually good for 25, variable for 19, and poor for 21. Māori patients were less likely to have good/usually good compliance than NZ European and Pacific patients (25% versus 44% and 47% respectively).

CONCLUSION

Referrals for CPAP treatment in the paediatric age range are increasing and obesity is the commonest co-morbidity. Services need to be culturally appropriate to ensure the best outcomes.

摘要

目的

记录惠灵顿地区小儿持续气道正压通气（CPAP）服务的建立，并回顾过去 15 年的结果。

方法

对 2005 年 11 月至 2020 年 12 月期间小儿睡眠服务记录中的小儿睡眠服务记录进行回顾性审计，包括开始 CPAP 治疗或提供 CPAP 治疗的所有儿科患者的临床信件和多导睡眠图（PSG）研究。收集的数据包括人口统计学、医学诊断、呼吸支持指征、耳鼻喉科参与和手术。还记录了与 CPAP 使用相关的因素。

结果

在规定的时间内，有 74 名儿童接受了 CPAP 治疗，其中 52 名（70%）为男性。CPAP 治疗开始时的年龄范围为<1 岁至 23 岁，其中 12 例年龄≥16 岁。有 3 例（4%）在 2006 年前就诊，11 例（15%）在 2006-2010 年就诊，16 例（22%）在 2011-2015 年就诊，44 例（59%）在 2016-2020 年就诊。种族包括 32 例（43%）新西兰欧洲人，18 例（24%）毛利人，19 例（26%）太平洋人，5 例（7%）印度/亚洲人。最常见的主要诊断是肥胖症 21 例（28%），唐氏综合征 10 例（14%）和颅面异常 8 例（11%）。有一个家庭拒绝了 CPAP 试验，有 8 个 CPAP 试验失败。对于其余 65 名患者，25 名患者对治疗的依从性良好/通常良好，19 名患者的依从性可变，21 名患者的依从性较差。毛利患者的良好/通常良好依从性比例低于新西兰欧洲和太平洋患者（分别为 25%、44%和 47%）。