Wilkinson A R, McCormick M S, Freeland A P, Pickering D
Br Med J (Clin Res Ed). 1981 May 16;282(6276):1579-81. doi: 10.1136/bmj.282.6276.1579.
Two children presented with sleep disturbances due to enlarged tonsils and adenoids. One child died during induction of anaesthesia, and postmortem examination showed hypertrophy of the right ventricle and atrium. As a result a prospective survey was carried out of children undergoing tonsillectomy or adenoidectomy, or both. During a nine-month period an electrocardiogram was taken in 92 children. Three electrocardiograms (3.3%) showed evidence of right heart strain. The children with abnormal electrocardiograms had symptoms of sleep disturbance with apnoea, snoring, and daytime somnolence. These symptoms and the electrocardiographic changes were reserved by adenotonsillectomy. The prevalence of pulmonary hypertension in children with enlarged tonsils and adenoids is still underestimated. When signs and symptoms of sleep disturbance, particularly snoring, are present an electrocardiogram should be obtained and a cardiologist's opinion sought before embarking on routine surgery in view of the potentially fatal consequences.
两名儿童因扁桃体和腺样体肿大出现睡眠障碍。一名儿童在麻醉诱导期间死亡，尸检显示右心室和右心房肥大。因此，对接受扁桃体切除术或腺样体切除术或两者皆做的儿童进行了一项前瞻性调查。在九个月的时间里，对92名儿童进行了心电图检查。三份心电图（3.3%）显示有右心劳损的迹象。心电图异常的儿童有睡眠呼吸暂停、打鼾和白天嗜睡等睡眠障碍症状。这些症状和心电图变化在腺样体扁桃体切除术后得到缓解。扁桃体和腺样体肿大儿童的肺动脉高压患病率仍被低估。鉴于潜在的致命后果，当出现睡眠障碍的体征和症状，尤其是打鼾时，应在进行常规手术前进行心电图检查并征求心脏病专家的意见。
