Gonsalez S, Thompson D, Hayward R, Lane R
Portex Anaesthesia, Intensive Therapy and Respiratory Medicine Unit, Institute of Child Health, London, UK.
Childs Nerv Syst. 1996 Nov;12(11):713-9. doi: 10.1007/BF00366156.
We studied a group of children (aged 2.2-15 years) with craniofacial dysostosis and obstructive sleep apnoea to assess the use of nasal continuous positive airway pressure (n-CPAP) as a palliative form of treatment. A variable period of time was allowed for acclimatisation to n-CPAP (1 day to 2 months), depending on the patient. Patients were then admitted for their first CPAP trial. Baseline breathing difficulty and the effectiveness of n-CPAP were assessed by respiratory sleep studies. Successful results were obtained with n-CPAP in five of the eight patients, with marked clinical and polygraphic improvements of the respiratory pattern immediately after n-CPAP was established. Of the remaining three cases, one child needed a prolonged period of acclimatisation to the n-CPAP system, one was withdrawn from the study, and one failed to respond to n-CPAP and was found to have complete blockage of the upper airways as a result of enlarged adenoids. Our results confirm that n-CPAP can be tolerated even by young patients and can be effective, and that it may be a useful alternative palliative treatment for obstructive sleep apnoea in children with craniofacial syndromes.
我们研究了一组患有颅面骨发育不全和阻塞性睡眠呼吸暂停的儿童（年龄在2.2至15岁之间），以评估使用鼻持续气道正压通气（n-CPAP）作为一种姑息性治疗方式的效果。根据患者情况，给予不同时长的时间来适应n-CPAP（1天至2个月）。然后患者入院进行首次CPAP试验。通过呼吸睡眠研究评估基线呼吸困难情况以及n-CPAP的有效性。8名患者中有5名使用n-CPAP取得了成功结果，在建立n-CPAP后，呼吸模式立即出现了显著的临床和多导睡眠图改善。其余3例中，1名儿童需要较长时间来适应n-CPAP系统，1名退出了研究，1名对n-CPAP无反应，经检查发现是由于腺样体肿大导致上呼吸道完全阻塞。我们的结果证实，即使是年幼患者也能耐受n-CPAP，且其可能有效，它可能是治疗颅面综合征儿童阻塞性睡眠呼吸暂停的一种有用的替代姑息治疗方法。
