Eckhardt P G, Bijlmer R P
Tijdschr Kindergeneeskd. 1984 Dec;52(6):212-7.
Four children were found to have clinically significant obstructive sleepapnea. Hypertrophy of the nasopharyngeal lymphoid tissue, specifically the adenoid and tonsils causing obstructive sleepapnea in children, is a well defined clinical entity with nocturnal CO2 retention, retarded growth and impaired physical and psychological status. A small number of these children may develop pulmonary hypertension, cor pulmonale and ultimately death. Children with only moderately enlarged tonsils in association with neuromuscular hypotonia and anatomical defects may also develop this syndrome. Polysomnographic monitoring during natural sleep proved useful in confirming the diagnosis. All patients had improved after surgical relief of airway obstruction. The subjective impressions were documented by objective improvement: normalization of growth curves, ECG improvement of cor pulmonale and improvement of bloodgasses. Increased awareness of obstructive sleepapnea and examination of the sleeping patient and polysomnographic monitoring should result in earlier treatment and less morbidity for children with obstructive sleepapnea.
发现有4名儿童患有具有临床意义的阻塞性睡眠呼吸暂停。鼻咽部淋巴组织肥大，特别是腺样体和扁桃体肥大导致儿童阻塞性睡眠呼吸暂停，是一种明确的临床病症，伴有夜间二氧化碳潴留、生长发育迟缓以及身体和心理状态受损。这些儿童中有少数可能会发展为肺动脉高压、肺心病并最终死亡。仅扁桃体中度肿大并伴有神经肌肉张力减退和解剖缺陷的儿童也可能会患上此综合征。自然睡眠期间的多导睡眠图监测被证明有助于确诊。所有患者在气道梗阻通过手术解除后病情均有改善。主观印象通过客观改善得到证实：生长曲线正常化、肺心病心电图改善以及血气改善。提高对阻塞性睡眠呼吸暂停的认识、对睡眠中的患者进行检查以及多导睡眠图监测，应能使阻塞性睡眠呼吸暂停儿童得到更早治疗并降低发病率。
